| CASE NUMBER | I-200-24085-826056 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/24/2024 |
| DECISION DATE | 3/29/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Supervisor Counselor |
| SOC CODE | 21-1014.00 |
| SOC TITLE | Mental Health Counselors |
| FULL TIME POSITION | Y |
| BEGIN DATE | 5/1/2024 |
| END DATE | 4/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Blossoming Cherry Mental Health Counseling Services P.C. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 213 Hempstead Avenue, Unit A |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Lynbrook |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 11563 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +15162569523 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62142 |
| EMPLOYER POC LAST NAME | Derri |
| EMPLOYER POC FIRST NAME | Jennifer |
| EMPLOYER POC MIDDLE NAME | L. |
| EMPLOYER POC JOB TITLE | Director Of Services |
| EMPLOYER POC ADDRESS1 | 213 Hempstead Avenue, Unit A |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Lynbrook |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 11563 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +15162569523 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | blossomingcherrymentalhealth@gmail.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Su |
| AGENT ATTORNEY FIRST NAME | Chenping |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | One World Trade Center, 285 Fulton St |
| AGENT ATTORNEY ADDRESS2 | Suite 8500 |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10007 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +12129206947 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | INFO@NYISLAWFIRM.COM |
| LAWFIRM NAME BUSINESS NAME | NYIS Law Firm |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | New York State Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 213 Hempstead Avenue, Unit A |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Lynbrook |
| WORKSITE COUNTY | NASSAU |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 11563 |
| WAGE RATE OF PAY FROM | 30 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $25.56 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business and Employment |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-05 |
