Azalea Counseling & Wellness, LLC
Organization Active NPI Community/Behavioral Health Agency · Newington, CT
NPI 1003209115 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1003209115
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 008089 (CT)
- Legal business name
- AZALEA COUNSELING & WELLNESS, LLC
- Practice address
- 100 Market SQ
Suite 16a
Newington, CT 06111-2921 - Phone
- (860) 888-2516
- NPI assigned
- Mar 13, 2015
- Organization subpart
- No
Authorized official
- Name
- Jennifer Elizabeth Brady, LCSW
- Title
- Owner
- Phone
- (860) 888-2516
Practitioners 1
-
Jennifer Elizabeth Brady, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170823000124 | CT | Part B Supplier - Clinic/Group Practice | 3779855929 |
Receives reassigned benefits from 1 practitioner Practice locations: Colchester, CT |
National Provider Directory
Locations
100 Market Sq
Ste 16A
Newington, CT 06111
Phone (860) 888-2516
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 008089 | CT | Yes |
Addresses
Primary practice location
100 Market SQ
Suite 16a
Newington, CT 06111-2921
Mailing address
100 Market SQ
Suite 16a
Newington, CT 06111-2921
Phone (860) 888-2516
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004025193 | Medicaid | CT |
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All providers in Newington, CT · Community/Behavioral Health Agency in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.