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General NPI Number Information
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NPI Number | 1780112268
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Entity Type | Individual
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Provider Name | SHONDA MONIQUE SESSOMS LPC
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Gender | Female
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 10 CANEBRAKE BLVD STE 110-14
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City | FLOWOOD
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State | MS
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Zip | 39232-2211
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Country | US
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Telephone | 769-268-1080
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Fax | 601-510-9598
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Provider Business Mailing Address
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Address Line | 10 CANEBRAKE BLVD STE 110-14
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City | FLOWOOD
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State | MS
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Zip | 39232-2211
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Country | US
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Telephone | 769-268-1080
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Fax | 601-510-9598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 10750-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 22744
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC017516
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1876
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC017516
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1876
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License Number State | MS
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