Healthcare Provider Details

I. General information

NPI: 1932843620
Provider Name (Legal Business Name): RECLAIMING YOUR PEACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 04/29/2022
Certification Date: 04/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 JEROME AVE
BLOOMFIELD CT
06002-2463
US

IV. Provider business mailing address

34 JEROME AVE
BLOOMFIELD CT
06002-2463
US

V. Phone/Fax

Practice location:
  • Phone: 860-281-4031
  • Fax:
Mailing address:
  • Phone: 860-281-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier8602814031
Identifier TypeOTHER
Identifier StateCT
Identifier IssuerPHONE

VIII. Authorized Official

Name: NADIA HOLMES
Title or Position: OWNER
Credential: LCSW
Phone: 860-281-4031