| Name: | Center For Psychiatry, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 08 Jan 1998 (27 years ago) |
| Date of dissolution: | 14 Aug 2013 |
| Entity Number: | 000-192-752 |
| Register Number: | 000192752 |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Principal Address: | GUNTERSVILLE, AL |
| Registered Office Street Address: | 2309 HWY 79 SOUTHGUNTERSVILLE, AL 35976 |
| Registered Office Street Address ZIP Code: | 35976 |
| Authorized Capital: | $1,000 |
Activities
PSYCHIATRIC AND COUNSELING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598832206 | 2006-11-29 | 2008-08-27 | PO BOX 959, GUNTERSVILLE, AL, 359760959, US | 1510 GUNTER AVE, GUNTERSVILLE, AL, 359761848, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-582-8833 |
| Fax | 2565828335 |
Authorized person
| Name | DR. MARY TRAYNOR |
| Role | OWNER |
| Phone | 2565828833 |
Taxonomy
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | 1457C |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| License Number | 4019 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529801490 |
| State | AL |
| Name | Role |
|---|---|
| GROFF, LAWANDA "BOOTS" | Agent |
| Name | Role |
|---|---|
| GROFF, LAWANDA "BOOTS" | Incorporator |
| TRAYNOR, MARY E | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
