Active NPI
Peaceful Minds Treatment Center LLC
- Adult Health Nurse Practitioner
- Waterbury, CT
National Provider Identifier
1578370326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- Legal business name
- PEACEFUL MINDS TREATMENT CENTER LLC
- Practice address
- 1389 W Main St
Suite 122
Waterbury, CT 06708-3104 - Phone
- (475) 689-3381
- Fax
- (203) 527-4697
- NPI assigned
- Dec 16, 2024
- Last updated
- Jun 15, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Annamarie Fraioli
- Title
- Owner
- Phone
- (203) 800-1642
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | NU | Primary |
Addresses
Primary practice location
1389 W Main St
Suite 122
Waterbury, CT 06708-3104
Mailing address
1389 W Main St
Suite 122
Waterbury, CT 06708-3104
Phone (475) 689-3381
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1389 W Main St
Ste 122
Waterbury, CT 06708
Phone (203) 800-1642
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Southbury, CT
- NPI 1952452872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734307200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781481600000",
"number": "1578370326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1389 W MAIN ST",
"address_2": "SUITE 122",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067083104",
"telephone_number": "475-689-3381",
"fax_number": "203-527-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1389 W MAIN ST",
"address_2": "SUITE 122",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067083104",
"telephone_number": "475-689-3381",
"fax_number": "203-527-4697"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEACEFUL MINDS TREATMENT CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-16",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A",
"authorized_official_last_name": "FRAIOLI",
"authorized_official_first_name": "ANNAMARIE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "203-800-1642"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.