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NORTH FORK COUNSELING SERVICES, LLC

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Company Details

Name: NORTH FORK COUNSELING SERVICES, LLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 17 Apr 2009 (16 years ago)
Financial Date End: 30 Apr 2026
Entity Number: 259477
Place of Formation: IDAHO
File Number: 259477
ZIP code: 83448
County: Madison County
Principal Address: 108 S AUSTIN AVE SUGAR CITY, ID 83448
Mailing Address: #2 2691 S 2000 W REXBURG, ID 83440

Agent

Name Role Address
JON M BURNHAM Agent 2691 S 2000 W, #2, REXBURG, ID 83440

Manager

Name Role Address Appointed On
Jon Burnham Manager 108 S AUSTIN AVE, SUGAR CITY, ID 83448 2021-03-17

National Provider Identifier

NPI Number:
1730873811
Certification Date:
2023-06-02

Authorized Person:

Name:
JON BURNHAM
Role:
OWNER/MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006146098 2025-03-06
Annual Report 0005632134 2024-03-04
Annual Report 0005164155 2023-03-21
Annual Report 0004666835 2022-03-22
Annual Report 0004212306 2021-03-17

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Date of last update: 06 May 2025

Sources: Idaho Secretary of State