Healthcare Provider Details

I. General information

NPI: 1881561215
Provider Name (Legal Business Name): VIBRANT PSYCHE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 10/21/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 WINDSOR AVE
WINDSOR CT
06095
US

IV. Provider business mailing address

PO BOX 1071
WINDSOR CT
06095-6171
US

V. Phone/Fax

Practice location:
  • Phone: 860-245-9883
  • Fax:
Mailing address:
  • Phone: 860-245-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAISY LOUISE GEATHERS
Title or Position: OWNER
Credential: APRN
Phone: 860-869-2254