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GLACIER PSYCHOLOGY SERVICES, PLLC

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Company Details

Name: GLACIER PSYCHOLOGY SERVICES, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 30 Mar 2021 (4 years ago)
Entity Number: 5976260
ZIP code: 11743
County: Suffolk
Place of Formation: New York
Address: 181 MAIN STREET, HUNTINGTON, NY, United States, 11743

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 181 MAIN STREET, HUNTINGTON, NY, United States, 11743

National Provider Identifier

NPI Number:
1316679129
Certification Date:
2022-06-29

Authorized Person:

Name:
KAYLA NELSON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
863151744
Plan Year:
2023
Number Of Participants:
3
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
210330000169 2021-03-30 ARTICLES OF ORGANIZATION 2021-03-30

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State