# IMAGE OF LIGHT MENTAL HEALTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124524798
- **Authorized official:** MIRIAM HAYNES APRN (OWNER)
- **Authorized official phone:** (860) 299-6677

## Contact information

- **Practice address:** 45 S MAIN ST STE 70, WEST HARTFORD, CT 06107
- **Practice address phone:** (860) 299-6677
- **Mailing address:** 53 BURNWOOD DR, BLOOMFIELD, CT 06002-2235
- **Mailing address phone:** (860) 299-6677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | CT | Yes |

## Other

- **Enumeration date:** 04/03/2018
- **Last updated:** 07/09/2018