Provider Demographics
NPI:1386735462
Name:SESSIONS, MICHAEL W (PHD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:SESSIONS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5807 LONG PARK RD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-5718
Mailing Address - Country:US
Mailing Address - Phone:770-844-0662
Mailing Address - Fax:770-844-0455
Practice Address - Street 1:5807 LONG PARK RD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-5718
Practice Address - Country:US
Practice Address - Phone:770-844-0662
Practice Address - Fax:770-844-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1164103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBDRQMedicare ID - Type Unspecified