Provider Demographics
NPI:1285161018
Name:SESSOMS, JENNIFER KRISTIE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KRISTIE
Last Name:SESSOMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3966 ELIZABETH GLEN WAY
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-7965
Mailing Address - Country:US
Mailing Address - Phone:336-687-4687
Mailing Address - Fax:
Practice Address - Street 1:3929 TINSLEY DR STE 104
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1531
Practice Address - Country:US
Practice Address - Phone:336-687-4687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional