Healthcare Provider Details

I. General information

NPI: 1780787408
Provider Name (Legal Business Name): TIMOTHY JOEL SESSIONS LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BLACKHORSE HILL RD PCL 116CM
COATESVILLE PA
19320-2040
US

IV. Provider business mailing address

49 DEYSHER RD
FLEETWOOD PA
19522-9739
US

V. Phone/Fax

Practice location:
  • Phone: 610-384-7711
  • Fax: 610-380-4337
Mailing address:
  • Phone: 610-301-3264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW012268L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: