Organization
CARBONELLI CONSULTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW CARBONELLI PHD (LICENSED PSYCHOLOGIST)
(224) 523-4236
Entity
Organization
Contact information
Practice address
3383 E LAYTON AVE, CUDAHY, WI 53110-1437
(224) 523-4236
Mailing address
3703 E ALLERTON AVE, CUDAHY, WI 53110-1108
(224) 523-4236
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/14/2025
Last updated
08/13/2025
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