NPIMap

Organization Active NPI

Mansfield Mental Health and Addiction Medicine

  • Psychiatry Physician
  • Mansfield Center, CT
National Provider Identifier
1366958480
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
54266 Issued in CT
Legal business name
MANSFIELD MENTAL HEALTH AND ADDICTION MEDICINE
Practice address
207 Storrs Rd
Mansfield Center, CT 06250-1638
Phone
(347) 872-3612
Fax
(860) 942-8830
NPI assigned
Dec 27, 2017
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gengyun Wen, MDNPI 1215367081
Title
Psychiatrist
Phone
(860) 336-8017

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU
Psychiatry Physician 2084P0800X 54266 CT Primary

Addresses

Primary practice location

207 Storrs Rd
Mansfield Center, CT 06250-1638

Mailing address

207 Storrs Rd
Mansfield Center, CT 06250-1638
Phone (860) 942-8826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210113002113 CT Part B Supplier - Clinic/Group Practice 6305259243 Receives reassigned benefits from 12 practitioners
Practice locations: Mansfield Center, CT

National Provider Directory

National Provider Directory

Locations

18E Ledgebrook Dr
Mansfield Ctr, CT 06250
Phone (860) 942-8826

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1366958480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501638",
            "telephone_number": "860-942-8826",
            "fax_number": "860-942-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 STORRS RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501638",
            "telephone_number": "347-872-3612",
            "fax_number": "860-942-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD MENTAL HEALTH AND ADDICTION MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-27",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "WEN",
        "authorized_official_first_name": "GENGYUN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "860-336-8017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "54266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield Center, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.