Provider Demographics
NPI:1447013701
Name:PELHAM-NYAN, CHARLOTTE KADIATU (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:KADIATU
Last Name:PELHAM-NYAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4119
Mailing Address - Country:US
Mailing Address - Phone:401-728-1800
Mailing Address - Fax:
Practice Address - Street 1:200 MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4119
Practice Address - Country:US
Practice Address - Phone:401-728-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical