Provider Demographics
NPI:1881778967
Name:ADELSTEIN, ANA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:ADELSTEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 SEMINOLE AVE NE STE 307
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-3416
Mailing Address - Country:US
Mailing Address - Phone:678-701-9559
Mailing Address - Fax:877-455-0324
Practice Address - Street 1:675 SEMINOLE AVENUE
Practice Address - Street 2:SUITE 307
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-3416
Practice Address - Country:US
Practice Address - Phone:678-701-9559
Practice Address - Fax:877-455-0324
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002524103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00923458CMedicaid
GA00923458AMedicaid
GA00923458BMedicaid
GA00923458DMedicaid
GA00923458DMedicaid
GA68BBFZZMedicare ID - Type UnspecifiedMEDICARE NUMBER