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Ignite Clinical Wellness Group, PLLC

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Company Details

Name: Ignite Clinical Wellness Group, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 25 Jul 2021 (4 years ago)
Business ID: 1295723
ZIP code: 38654
County: DeSoto
State of Incorporation: MISSISSIPPI
Principal Office Address: 5600 Goodman Road, Suite GOlive Branch, MS 38654

Agent

Name Role Address
Registered Agents Inc Agent 270 Trace Colony Park, Suite B, Ridgeland, MS 39157

Manager

Name Role Address
Kattrina Miller Roach Manager 4255 Shinault Lane, Olive Branch, MS 38654

National Provider Identifier

NPI Number:
1184305666
Certification Date:
2023-07-27

Authorized Person:

Name:
DERRICK O ROACH
Role:
CHIEF OPERATIONS OFFICER
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
101YP2500X - Professional Counselor
Is Primary:
No
Selected Taxonomy:
261QM0801X - Mental Health Clinic/Center (Including Community Mental Health Center)
Is Primary:
Yes

Contacts:

Fax:
6624047288

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-01-21 Annual Report For Ignite Clinical Wellness Group, PLLC
Annual Report LLC Filed 2024-11-15 Annual Report For Ignite Clinical Wellness Group, PLLC
Annual Report LLC Filed 2024-01-31 Annual Report For Ignite Clinical Wellness Group, PLLC
Annual Report LLC Filed 2023-04-12 Annual Report For Ignite Clinical Wellness Group, PLLC
Annual Report LLC Filed 2023-01-19 Annual Report For Ignite Clinical Wellness Group, PLLC
Annual Report LLC Filed 2022-04-14 Annual Report For Ignite Clinical Wellness Group, PLLC
Formation Form Filed 2021-07-25 Formation For Ignite Clinical Wellness Group, PLLC

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Date of last update: 27 May 2025

Sources: Company Profile on Mississippi Secretary of State Website