TRACEY CORNELLA-CARLSON


Address: 721 American Ave Ste 501, Waukesha, WI 53188-5071
Phone: 2629284036

TRACEY CORNELLA-CARLSON (NPI# 1730134412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730134412
Entity Type Individual
Full Name TRACEY CORNELLA-CARLSON
Credential MD
Practice Address 721 American Ave Ste 501
Waukesha
WI 53188-5071
Practice Telephone 2629284036
Mailing Telephone 2629284036
Enumeration Date 2006-05-23
Last Update Date 2019-01-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084P0804X Psychiatry & Neurology
Specialization: Child & Adolescent Psychiatry
48673 WI Allopathic & Osteopathic Physicians

Office Location

Street Address 721 AMERICAN AVE STE 501
City WAUKESHA
State WI
Zip Code 53188-5071

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558918516 Elizabeth Arndorfer Counselor 721 American Ave Ste 501, Waukesha, WI 53188-5071 2019-08-23
1376007948 Carrie Laux Social Worker 721 American Ave Ste 501, Waukesha, WI 53188-5071 2019-01-28
1568936946 Julie Kaczmarek Social Worker 721 American Ave Ste 501, Waukesha, WI 53188-5071 2019-01-18
1568947158 Emily Gill Social Worker 721 American Ave Ste 501, Waukesha, WI 53188-5071 2018-09-28
1275018228 Kathleen Ball Social Worker 721 American Ave Ste 501, Waukesha, WI 53188-5071 2018-09-26
1962992537 Marissa Mowery Counselor 721 American Ave Ste 501, Waukesha, WI 53188-5071 2018-05-18
1417477209 Ellen M Majowski Social Worker 721 American Ave Ste 501, Waukesha, WI 53188-5071 2017-06-22
1467880641 Mollie Jenkins Nurse Practitioner 721 American Ave Ste 501, Waukesha, WI 53188-5071 2013-10-24
1013266980 Amanda J Dowling Counselor 721 American Ave Ste 501, Waukesha, WI 53188-5071 2012-09-06
1053551671 Christopher John Borden Counselor 721 American Ave Ste 501, Waukesha, WI 53188-5071 2009-02-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1336787126 Nicole Lee Berg-johnson Nurse Practitioner 820 Crestwood Dr., Waukesha, WI 53188 2019-12-12
1013475706 Rachel Mueller Occupational Therapist 29667 Summit Ave, S11, Waukesha, WI 53188 2019-03-12
1861962649 Emily Elizabeth Seefeld Occupational Therapy Assistant 29667 Summit Ave S11, Waukesha, WI 53188 2018-12-05
1003393307 Ashley Susan Callahan Dental Hygienist 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 2018-07-19
1245741321 Melissa Weir Case Manager/Care Coordinator 514 Riverview Avenue, Waukesha, WI 53188 2017-10-17
1093233629 Patricia Marie Sombrio Dental Hygienist 711 Moreland Blvd 204, Waukesha, WI 53188 2017-09-04
1134660244 Bdg of Wisconsin, Inc. Behavioral Analyst N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 2017-03-09
1255888731 Lynne Sarah Alva Dental Hygienist 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 2016-09-01
1881069730 Michelle Koch Occupational Therapist 29667 Summit Ave. S11, Waukesha, WI 53188 2015-12-03
1952711012 Rhonda Schroeder Dental Hygienist W286 N991 Shepherds Way, Waukesha, WI 53188 2014-04-29
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Taxonomy Information

Taxonomy Code 2084P0804X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Child & Adolescent Psychiatry

Taxonomy Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1124091749 Paul Larson Psychiatry & Neurology 721 American Avenue Suite 501, Phc Behavioral Medicine Center, Waukesha, WI 53188 2006-02-13
1083649925 Maritoni Molina Abraham Psychiatry & Neurology 20700 Watertown Rd, Suite 102, Waukesha, WI 53186-1800 2006-07-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1104384387 Center for Emotional Wellness LLC. Psychiatry & Neurology W156n8327 Pilgrim Rd Ste 301, Menomonee Fls, WI 53051-3776 2019-03-06
1295000255 Ilsa Bick Psychiatry & Neurology 1099 Highland Dr, Kohler, WI 53044-1306 2012-03-09
1215268453 Richard Carl Zimmerman Psychiatry & Neurology 1282 E. Green Lake Dr., West Bend, WI 53090-9069 2010-01-28
1184800880 William M Buzogany Psychiatry & Neurology W350 S1401 Waterville Road, Lad Lake Inc, Dousman, WI 53118 2008-01-14
1033300199 Monika Drummond Roots Psychiatry & Neurology 3140 Oxford Rd, Madison, WI 53705-2224 2007-08-05
1598974321 Marta Cristina Muller Psychiatry & Neurology 1941 N Battle Creek Rd, Oconomowoc, WI 53066-9468 2007-05-21
1164517082 Moitreyee Bandyopadhyay Reddy Psychiatry & Neurology 9000 W.wisconsin Avenue, Milwaukee, WI 53201-1997 2006-10-04
1639182868 Thomas E. Wright Psychiatry & Neurology 120 East Main Street, Cambridge, WI 53523-0548 2006-08-15
1447262183 Neil P Fullan Psychiatry & Neurology 2475 University Ave Ste A, Green Bay, WI 54302-5099 2006-08-12
1396761276 Robert Perzacki Psychiatry & Neurology 1820 Appleton Rd, Menasha, WI 54952-1110 2006-07-14
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Competitor

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City WAUKESHA
Zip Code 53188

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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