Kristin Shea Adams-Pelham, PSY.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY003461 Issued in GA

Practice address

830 Spring Creek Rd Ste a
Bainbridge, GA 39817-3554

Phone

(954) 609-4966

NPI assigned

Feb 5, 2024

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047

  Clinical

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1689437428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SPRING CREEK RD STE A",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398173554",
            "telephone_number": "954-609-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SPRING CREEK RD STE A",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398173554",
            "telephone_number": "954-609-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS-PELHAM",
        "first_name": "KRISTIN",
        "middle_name": "SHEA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7930",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "GA",
            "license": "PSY003461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Adams
• Agape Serenity Home LLC
• Omar Al Haddad, MD
• Amazing Body Transformations
• Kayla Anderson-Williams

• Forensic Psychologist in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Forensic Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.