Healthcare Provider Details

I. General information

NPI: 1871427195
Provider Name (Legal Business Name): PEACEFUL PATH THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MAIN ST FL 1
EAST HAVEN CT
06512-2506
US

IV. Provider business mailing address

97 TWIN LAKES RD
NORTH BRANFORD CT
06471-1213
US

V. Phone/Fax

Practice location:
  • Phone: 203-444-8539
  • Fax:
Mailing address:
  • Phone: 203-444-8539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MORGAN RAYNER
Title or Position: OWNER
Credential:
Phone: 203-444-8539