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MASONICARE BEHAVIORAL HEALTH, LLC
NPI 1992781488
Psychiatry & Neurology - Geriatric Psychiatry in Wallingford, CT

Active since December 16, 2005
67 MASONIC AVE, 1ST FLOOR, WALLINGFORD, CT 06492(203) 265-5720(203) 679-5623 Get Directions Write a Review

NPPES record last updated: June 6, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Masonicare Behavioral Health, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MASONICARE BEHAVIORAL HEALTH, LLC (NPI 1992781488) is a healthcare organization registered as a geriatric psychiatry in Wallingford, Connecticut and active in the NPI registry since December 2005. The organization lists John Tibbetts, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1992781488
Entity TypeOrganization
Primary Taxonomy2084P0805X
Legal Business NameMASONICARE BEHAVIORAL HEALTH, LLC
Location Address67 MASONIC AVE, 1ST FLOORWallingford, CT 06492-3095
Mailing Address67 Masonic Ave, 1st FloorWallingford, CT 06492-3095 · (203) 265-5720 · Fax (203) 679-5623
Phone(203) 265-5720
Fax(203) 679-5623
Organization SubpartYesParent: Masonicare Primary Care Physicians, Pc
Authorized OfficialJohn TibbettsAuthorized Official · (203) 265-5720
Enumeration DateDecember 16, 2005
Last NPPES UpdateJune 6, 2014
✔ NPI 1992781488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Geriatric PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0805X
Definition
Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients.
67 MASONIC AVE, Wallingford, CT 06492
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Other Identifiers 2

Medicaid004183050CT
Medicare PINC02770CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YALE UNIVERSITY
Durable Medical Equipment & Medical Supplies
67 MASONIC AVE
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (877) 925-3637
ALLA BERNSHTEYN MD
Internal Medicine
67 MASONIC AVE, 1ST FLOOR
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 265-0355
KATHRYN E MACARY APRN
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
67 MASONIC AVE, 1ST FLOOR
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 265-5720
DONNA L MARIANO APRN
Nurse Practitioner (Primary Care)
67 MASONIC AVE, SUITE 3100
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 284-3144
JOHN HUANG M.D.
Internal Medicine
67 MASONIC AVE, SUITE 3100
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 284-3144
COMPREHENSIVE NEUROLOGY AND PAIN CENTER OF CONNECTICUT, LLC
Pain Medicine (Interventional Pain Medicine)
67 MASONIC AVE, SUITE 2400
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 626-9080
LAELA SIMON OTR/L
Occupational Therapist
67 MASONIC AVE
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 314-4954
JAVIER SALABARRIA MD
Psychiatry & Neurology (Geriatric Psychiatry)
67 MASONIC AVE
WALLINGFORD, CT 06492
South Central Connecticut Planning Region (203) 265-5720

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Masonicare Behavioral Health, LLC's NPI number?

The NPI number for Masonicare Behavioral Health, LLC is 1992781488. It was assigned to this organization in the NPPES registry on December 16, 2005.

Where is Masonicare Behavioral Health, LLC located?

Masonicare Behavioral Health, LLC is located at 67 Masonic Ave 1st Floor, Wallingford, CT 06492. The listed phone number is (203) 265-5720.

What is Masonicare Behavioral Health, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Geriatric Psychiatry, with taxonomy code 2084P0805X.

When was this NPI record last updated?

The NPPES record for Masonicare Behavioral Health, LLC was last updated on June 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.