Healthcare Provider Details

I. General information

NPI: 1235043183
Provider Name (Legal Business Name): PEACEFUL HEART COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 MAIN ST
SOMERS CT
06071-2102
US

IV. Provider business mailing address

795 CHAPEL RD
SOUTH WINDSOR CT
06074-4204
US

V. Phone/Fax

Practice location:
  • Phone: 401-400-1078
  • Fax:
Mailing address:
  • Phone: 508-333-1599
  • 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: ABIGAIL BERND
Title or Position: MANAGER
Credential:
Phone: 401-400-1078