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SUSAN CONNELLY LICENSED CLINICAL SOCIAL WORKER P.C.

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Company Details

Name: SUSAN CONNELLY LICENSED CLINICAL SOCIAL WORKER P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 04 May 2018 (7 years ago)
Entity Number: 5335575
ZIP code: 13760
County: Broome
Place of Formation: New York
Address: 515 EAST MAIN STREET, ENDICOTT, NY, United States, 13760

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 515 EAST MAIN STREET, ENDICOTT, NY, United States, 13760

National Provider Identifier

NPI Number:
1467930453
Certification Date:
2020-04-23

Authorized Person:

Name:
SUSAN L CONNELLY
Role:
OWNER/PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Fax:
6074443319

Filings

Filing Number Date Filed Type Effective Date
180504000227 2018-05-04 CERTIFICATE OF INCORPORATION 2018-05-04

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State