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COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING P.C.

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Company Details

Name: COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 15 Apr 2020 (5 years ago)
Entity Number: 5738440
ZIP code: 11940
County: Kings
Place of Formation: New York
Address: 136 PINE STREET, EAST MORICHES, NY, United States, 11940
Principal Address: 136 Pine Street, East Moriches, NY, United States, 11940

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Agent

Name Role Address
UNITED AGENT SERVICES LLC Agent 7014 13TH AVENUE, #217, BROOKLYN, NY, 11228

DOS Process Agent

Name Role Address
COLLABORATIVE THERAPY MENTAL HEALTH COUNSELING P.C. DOS Process Agent 136 PINE STREET, EAST MORICHES, NY, United States, 11940

Chief Executive Officer

Name Role Address
KYLE MCEVOY Chief Executive Officer 136 PINE STREET, EAST MORICHES, NY, United States, 11940

National Provider Identifier

NPI Number:
1437773611
Certification Date:
2025-02-06

Authorized Person:

Name:
KYLE WILLIAM MCEVOY
Role:
FOUNDER & LMHC
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
101Y00000X - Counselor
Is Primary:
No
Selected Taxonomy:
101YP2500X - Professional Counselor
Is Primary:
No
Selected Taxonomy:
102L00000X - Psychoanalyst
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
9294199061

Form 5500 Series

Employer Identification Number (EIN):
850766492
Plan Year:
2024
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
14
Sponsors Telephone Number:

History

Start date End date Type Value
2020-04-15 2021-01-27 Address 1 S 1ST ST., APT 37A, BROOKLYN, NY, 11249, USA (Type of address: Service of Process)
2020-04-15 2024-09-13 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
220930018059 2022-09-30 BIENNIAL STATEMENT 2022-04-01
210127000261 2021-01-27 CERTIFICATE OF CHANGE 2021-01-27
210108000207 2021-01-08 CERTIFICATE OF CHANGE 2021-01-08
200415000651 2020-04-15 CERTIFICATE OF INCORPORATION 2020-04-15

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State