| Name: | Krystina M. White, LICSW, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Oct 2022 (2 years ago) |
| Entity Number: | 001-046-499 |
| Register Number: | 001046499 |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 9238 Madison Blvd, Suite 116Madison, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659089365 | 2022-11-10 | 2024-06-17 | 23884 WALES ST, ELKMONT, AL, 356203857, US | 11 HUGHES RD STE 202, MADISON, AL, 357583037, US | |||||||||||||
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| Phone | +1 256-694-3856 |
Authorized person
| Name | KRYSTINA WHITE |
| Role | OWNER |
| Phone | 2569751023 |
Taxonomy
| Taxonomy Code | 261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center) |
| Is Primary | Yes |
| Name | Role |
|---|---|
| White, Krystina M | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
