Healthcare Provider Details

I. General information

NPI: 1750168746
Provider Name (Legal Business Name): FATMATA K SESAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 SETTLERS WAY
STAFFORD VA
22554-7604
US

IV. Provider business mailing address

29 SETTLERS WAY
STAFFORD VA
22554-7604
US

V. Phone/Fax

Practice location:
  • Phone: 703-884-6977
  • Fax:
Mailing address:
  • Phone: 703-884-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: