Healthcare Provider Details

I. General information

NPI: 1902552268
Provider Name (Legal Business Name): CIRCLE OF PEACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2022
Last Update Date: 10/14/2026
Certification Date: 10/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MECHANIC ST STE 1015
WINDSOR CT
06095-2545
US

IV. Provider business mailing address

41 MECHANIC ST STE 1015
WINDSOR CT
06095-2545
US

V. Phone/Fax

Practice location:
  • Phone: 860-513-2786
  • Fax:
Mailing address:
  • Phone: 860-513-2786
  • 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: JASMINE HALL
Title or Position: OWNER
Credential:
Phone: 860-513-2786