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WELLROUND PROVIDER GROUP, P.A.

Branch

Company Details

Name: WELLROUND PROVIDER GROUP, P.A.
Jurisdiction: New York
Legal type: FOREIGN PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 14 Nov 2019 (6 years ago)
Branch of: WELLROUND PROVIDER GROUP, P.A., Florida (Company Number P19000033546)
Entity Number: 5655903
ZIP code: 10528
County: New York
Place of Formation: Florida
Address: 600 MAMARONECK AVENUE #400, HARRISON, NY, United States, 10528
Principal Address: 26 Broadway Ste 318, New York, NY, United States, 10004

Agent

Name Role Address
CORPORATE CREATIONS NETWORK INC. Agent 600 MAMARONECK AVENUE #400, HARRISON, NY, 10528

DOS Process Agent

Name Role Address
C/O CORPORATE CREATIONS NETWORK INC. DOS Process Agent 600 MAMARONECK AVENUE #400, HARRISON, NY, United States, 10528

Chief Executive Officer

Name Role Address
NORA FELDPAUSCH Chief Executive Officer 26 BROADWAY STE 318, NEW YORK, NY, United States, 10004

National Provider Identifier

NPI Number:
1194351965
Certification Date:
2020-03-12

Authorized Person:

Name:
DR. KRISTEL CARRINGTON
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2023-11-07 2023-11-07 Address 228 PARK AVE S PMB 88524, NEW YORK, NY, 10003, USA (Type of address: Chief Executive Officer)
2023-11-07 2023-11-07 Address 26 BROADWAY STE 318, NEW YORK, NY, 10004, USA (Type of address: Chief Executive Officer)
2022-06-19 2023-11-07 Address 600 MAMARONECK AVENUE #400, HARRISON, NY, 10528, USA (Type of address: Registered Agent)
2022-06-19 2023-11-07 Address 228 PARK AVE S PMB 88524, NEW YORK, NY, 10003, USA (Type of address: Chief Executive Officer)
2022-06-19 2023-11-07 Address 600 MAMARONECK AVENUE #400, HARRISON, NY, 10528, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
231107002736 2023-11-07 BIENNIAL STATEMENT 2023-11-01
220619000039 2022-06-17 CERTIFICATE OF CHANGE BY ENTITY 2022-06-17
211105000499 2021-11-05 BIENNIAL STATEMENT 2021-11-05
200602000473 2020-06-02 CERTIFICATE OF CHANGE 2020-06-02
191114000222 2019-11-14 APPLICATION OF AUTHORITY 2019-11-14

Date of last update: 23 Mar 2025

Sources: New York Secretary of State