Colette L Audax, SWT
Individual provider Active NPI Social Worker · Fairfield, OH
NPI 1003515966 · NPPES record last updated Oct 8, 2025
Key facts
- NPI
- 1003515966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.2504279-TRNE (OH)
- Practice address
- 1251 Nilles Rd Ste 4And5
Fairfield, OH 45014-7206 - Phone
- (888) 830-0347
- NPI assigned
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.2504279-TRNE | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindfully Psychiatry LLC | Past | Accepting new patients | |
| Mindfully, LLC | Social Worker | Past | Accepting new patients |
| Mindfully, LLC | Social Worker | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.2504279-TRNE | OH | Yes |
Addresses
Primary practice location
1251 Nilles Rd Ste 4And5
Fairfield, OH 45014-7206
Mailing address
1600 Thompson Heights Ave Apt 308
Cincinnati, OH 45223-1678
Phone (513) 833-7814
Other providers in Fairfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.