Individual
DR. MAX MASTELLONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
330 N CAMPO ST, LAS CRUCES, NM 88001-3433
(609) 706-5931
(505) 521-6259
Mailing address
2615 CASHMERE CT, LAS CRUCES, NM 88011-0800
(609) 706-5931
(505) 521-6259
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0953
NM
103TM1800X
Intellectual & Developmental Disabilities Psychologist
0953
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22559302
—
NM
05
—
39980847
—
NM
Enumeration date
01/09/2007
Last updated
09/11/2025
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