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  5. JESSICA C. SULLIVAN LCSW PLLC

JESSICA C. SULLIVAN LCSW PLLC

Company Details

Name: JESSICA C. SULLIVAN LCSW PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 21 Aug 2018 (6 years ago)
Entity Number: 5396605
ZIP code: 10950
County: Orange
Place of Formation: New York
Address: 360 ROUTE 17M, STE 4, MONROE, NY, United States, 10950

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NOURISH YOUR MIND 401(K) PLAN 2023 831864620 2024-05-24 JESSICA C. SULLIVAN LCSW PLLC 36
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2023-02-10
Business code 621330
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE 4, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-05-24
Name of individual signing QIAN LIU
NOURISH YOUR MIND 401(K) PLAN 2021 831864620 2022-07-07 JESSICA C. SULLIVAN LCSW, PLLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-12-04
Business code 624100
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE #4, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-07-07
Name of individual signing CHRISTINE RIMER
NOURISH YOUR MIND 401(K) PLAN 2021 831864620 2022-11-29 JESSICA C. SULLIVAN LCSW, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-12-04
Business code 624100
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE #4, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-11-29
Name of individual signing CHRISTINE RIMER
NOURISH YOUR MIND 401(K) PLAN 2021 831864620 2022-05-03 JESSICA C. SULLIVAN LCSW, PLLC 11
Three-digit plan number (PN) 001
Effective date of plan 2018-12-04
Business code 624100
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE #4, MONROE, NY, 10950

Signature of
Role Plan administrator
Date 2022-05-03
Name of individual signing CHRISTINE RIMER
NOURISH YOUR MIND 401(K) PLAN 2020 831864620 2021-05-31 JESSICA C. SULLIVAN LCSW, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-12-04
Business code 624100
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE #4, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-05-31
Name of individual signing CAROL HO
JESSICA C. SULLIVAN LCSW 401(K) PLAN 2019 831864620 2020-07-01 JESSICA C. SULLIVAN LCSW, PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-12-04
Business code 624100
Sponsor’s telephone number 8455470479
Plan sponsor’s address 360 ROUTE 17M, SUITE #4, MONROE, NY, 10950

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing CAROL HO

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 360 ROUTE 17M, STE 4, MONROE, NY, United States, 10950

Filings

Filing Number Date Filed Type Effective Date
220802001576 2022-08-02 BIENNIAL STATEMENT 2022-08-01
211029000963 2021-10-29 BIENNIAL STATEMENT 2021-10-29
190109000307 2019-01-09 CERTIFICATE OF PUBLICATION 2019-01-09
180821000055 2018-08-21 ARTICLES OF ORGANIZATION 2018-08-21

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Related by address

No related companies by address

Date of last update: 22 Nov 2024

Sources: New York Secretary of State

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