15-63 208TH PLACE, BAYSIDE, 11360, NEW YORK
					
				| Entity Name | ACTIVE CHANGE PSYCHOLOGICAL SERVICES, PLLC | 
| Entity Number | 5763313 | 
| Status | ACTIVE | 
| Incorporation Date | 8th June 2020 | 
| Dos Process Address | 6800 JERICHO TPKE., STE 120W, SYOSSET, 11791, NEW YORK | 
| Jurisdiction | NEW YORK | 
| County | NASSAU | 
| Legal form | DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY |