Healthcare Provider Details

I. General information

NPI: 1659276855
Provider Name (Legal Business Name): GLIMMERS OF HOPE THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CASE ST STE 302
NORWICH CT
06360-2222
US

IV. Provider business mailing address

66 FRANKLIN ST
NORWICH CT
06360-5806
US

V. Phone/Fax

Practice location:
  • Phone: 860-816-3968
  • Fax:
Mailing address:
  • Phone: 860-816-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JADIRA ELOISE BREAULT
Title or Position: MANAGING MEMBER
Credential: LPC
Phone: 860-816-3968