Healthcare Provider Details

I. General information

NPI: 1104556315
Provider Name (Legal Business Name): KAYLA MARIE SESNY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 06/13/2022
Certification Date: 06/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 FOREST AVE
STATEN ISLAND NY
10303-2127
US

IV. Provider business mailing address

61 SHOTWELL AVE SIDE
STATEN ISLAND NY
10312-1929
US

V. Phone/Fax

Practice location:
  • Phone: 718-981-3136
  • Fax:
Mailing address:
  • Phone: 347-466-1318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: