Healthcare Provider Details

I. General information

NPI: 1396672069
Provider Name (Legal Business Name): CARBONE CBT & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 NATURES WAY
LINDENHURST IL
60046-1706
US

IV. Provider business mailing address

1622 NATURES WAY
LINDENHURST IL
60046-1706
US

V. Phone/Fax

Practice location:
  • Phone: 708-945-7833
  • Fax:
Mailing address:
  • Phone: 708-945-7833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CARBONE
Title or Position: OWNER
Credential: LCSW
Phone: 708-945-7833