Healthcare Provider Details

I. General information

NPI: 1316518046
Provider Name (Legal Business Name): KELLY AKEHURST LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2021
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 HIGH RIDGE RD STE 137
STAMFORD CT
06905-1221
US

IV. Provider business mailing address

431 DURHAM RD
MADISON CT
06443-2041
US

V. Phone/Fax

Practice location:
  • Phone: 475-477-0278
  • Fax:
Mailing address:
  • Phone: 917-592-8644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4975
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: