Provider Demographics
NPI:1124832456
Name:CHESSON, SETH
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:CHESSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 GOLD HILL RD STE 221
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7946
Mailing Address - Country:US
Mailing Address - Phone:803-752-0173
Mailing Address - Fax:
Practice Address - Street 1:885 GOLD HILL RD STE 221
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7946
Practice Address - Country:US
Practice Address - Phone:803-752-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10252101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional