Healthcare Provider Details

I. General information

NPI: 1659207264
Provider Name (Legal Business Name): EQUILIBRIUM PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 OLD FARMS RD
SOUTH GLASTONBURY CT
06073-3713
US

IV. Provider business mailing address

195 OLD FARMS RD
SOUTH GLASTONBURY CT
06073-3713
US

V. Phone/Fax

Practice location:
  • Phone: 860-901-1867
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LISA QUARANTA
Title or Position: OWNER/APRN
Credential: APRN
Phone: 203-260-3794