Provider Demographics
NPI:1104556315
Name:SESNY, KAYLA MARIE (LMSW)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:SESNY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SHOTWELL AVE SIDE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1929
Mailing Address - Country:US
Mailing Address - Phone:347-466-1318
Mailing Address - Fax:
Practice Address - Street 1:1915 FOREST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2127
Practice Address - Country:US
Practice Address - Phone:718-981-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty