| Masino Mental Health Services, Inc | |
|
507 John Sims Pkwy E Niceville FL 32578-2027 | |
| (850) 424-5210 | |
| (850) 424-3220 |
| Full Name | Masino Mental Health Services, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 507 John Sims Pkwy E, Niceville, Florida |
| Authorized Official Name and Position | Theodore P Masino (OWNER) |
| Authorized Official Contact | 8504245210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Masino Mental Health Services, Inc 507 John Sims Pkwy E Niceville FL 32578-2027 Ph: (850) 424-5210 | Masino Mental Health Services, Inc 507 John Sims Pkwy E Niceville FL 32578-2027 Ph: (850) 424-5210 |
| NPI Number | 1700214228 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 10/14/2025 |
| Certification Date | 10/14/2025 |
| Medicare PECOS PAC ID | 9638305964 |
|---|---|
| Medicare Enrollment ID | O20131115000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700214228 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY6920 (Florida) | Primary |
| Provider Name | Theodore P Masino |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144214792 PECOS PAC ID: 0345300018 Enrollment ID: I20081125000742 |
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