Healthcare Provider Details

I. General information

NPI: 1811018104
Provider Name (Legal Business Name): GERILYN CATHERINE SESTOK LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 BIRCH RD
HIGHLAND MILLS NY
10930-2935
US

IV. Provider business mailing address

20 BIRCH RD
HIGHLAND MILLS NY
10930-2935
US

V. Phone/Fax

Practice location:
  • Phone: 845-928-8980
  • Fax:
Mailing address:
  • Phone: 845-928-8980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberR041941-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: