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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
48673 | WI | Allopathic & Osteopathic Physicians |
Street Address |
721 AMERICAN AVE STE 501 |
City | WAUKESHA |
State | WI |
Zip Code | 53188-5071 |
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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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 |
Find all providers in zip 53188 |
Taxonomy Code | 2084P0804X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Child & Adolescent Psychiatry |
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] |
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 |
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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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.