Provider Demographics
NPI:1992930853
Name:SEJOURNE, KATHRYN Z (LPC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:Z
Last Name:SEJOURNE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LANTERN HILL LN
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2066
Mailing Address - Country:US
Mailing Address - Phone:203-453-1248
Mailing Address - Fax:203-503-3352
Practice Address - Street 1:786 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-3036
Practice Address - Country:US
Practice Address - Phone:203-668-0557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004754101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCBH12267KSMedicaid
CT004235918Medicaid