Provider Demographics
NPI:1215527171
Name:SESSUMS, KATELYN (MS)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:SESSUMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 MINOR RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1630
Mailing Address - Country:US
Mailing Address - Phone:769-241-1066
Mailing Address - Fax:
Practice Address - Street 1:3040 AVEMORE SQUARE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7228
Practice Address - Country:US
Practice Address - Phone:434-220-0089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001877103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst