Healthcare Provider Details

I. General information

NPI: 1043144306
Provider Name (Legal Business Name): AXIS BEHAVIORAL HEALTH & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 TURNER LN
TEMPLETON MA
01468-1565
US

IV. Provider business mailing address

148 TURNER LN
TEMPLETON MA
01468-1565
US

V. Phone/Fax

Practice location:
  • Phone: 978-613-1513
  • Fax: 978-451-9356
Mailing address:
  • Phone: 978-613-1513
  • Fax: 978-451-9356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER NOLIN
Title or Position: OWNER
Credential: PMHNP
Phone: 978-613-1513