Provider Demographics
NPI:1689437428
Name:ADAMS-PELHAM, KRISTIN SHEA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:SHEA
Last Name:ADAMS-PELHAM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SPRING CREEK RD STE A
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39817-3554
Mailing Address - Country:US
Mailing Address - Phone:954-609-4966
Mailing Address - Fax:
Practice Address - Street 1:830 SPRING CREEK RD STE A
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39817-3554
Practice Address - Country:US
Practice Address - Phone:954-609-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7930103TC0700X
GAPSY003461103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical