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MCKENSIE CLEAVENGER THERAPY LLC

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Company Details

Legal Name: MCKENSIE CLEAVENGER THERAPY LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: July 30th 2019
Expiration date: 31 Jul 2025
UBI Number: 604 482 096
ZIP code: 99352
City: Richland
County: BENTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 404 BRADLEY BLVD, SUITE 200, RICHLAND, WA, 99352-4500, UNITED STATES

Contact Details

E-Mail: KENSIECLEAVENGER.MFT@GMAIL.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
MCKENSIE KILSTROM Registered Agent 404 BRADLEY BLVD, SUITE 200, RICHLAND, WA, 99352-4500, UNITED STATES

Key Officers & Management

Name Role Address
RICHARD BERG Executor 7211 SANDY RIDGE RD, PASCO, WA, 99301-9379, UNITED STATES
MCKENSIE KILSTROM Governing Person 3101 E BOONE AVE, SPOKANE, WA, 99202, UNITED STATES

National Provider Identifier

NPI Number:
1720702749
Certification Date:
2022-10-26

Authorized Person:

Name:
MCKENSIE CLEAVENGER
Role:
PROVIDER/SOLE OWNER
Phone:

Taxonomy:

Selected Taxonomy:
106H00000X - Marriage & Family Therapist
Is Primary:
Yes

Contacts:

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