Jody Elizabeth Axt

Individual provider Active NPI Professional Counselor · Bristol, CT

NPI 1619837804 · NPPES record last updated Nov 12, 2025

Key facts

NPI
1619837804
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
Practice address
1 Hope St
Bristol, CT 06010-6374
Phone
(860) 793-4206
NPI assigned
Nov 12, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YP2500X Yes

Addresses

Primary practice location

1 Hope St
Bristol, CT 06010-6374

Mailing address

54 Grieb TRL
Wallingford, CT 06492-2659
Phone (860) 793-4206

Other providers in Bristol, CT

All providers in Bristol, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.