Provider Demographics
NPI:1770122467
Name:ADAMS, KELLEE K
Entity type:Individual
Prefix:
First Name:KELLEE
Middle Name:K
Last Name:ADAMS
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 1:20 WENDELL ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-1214
Mailing Address - Country:US
Mailing Address - Phone:516-605-7777
Mailing Address - Fax:
Practice Address - Street 1:20 WENDELL ST APT 2F
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-1214
Practice Address - Country:US
Practice Address - Phone:516-605-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty