Provider Demographics
NPI:1528743853
Name:CARBONE, NICOLETTA
Entity type:Individual
Prefix:
First Name:NICOLETTA
Middle Name:
Last Name:CARBONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 E WARNER RD STE 115
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3133
Mailing Address - Country:US
Mailing Address - Phone:480-590-3915
Mailing Address - Fax:
Practice Address - Street 1:1206 E WARNER RD STE 115
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3133
Practice Address - Country:US
Practice Address - Phone:480-590-3915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health