Provider Demographics
NPI:1629743307
Name:SESNON, TYLER CLAY (MS, LPC, MHCA)
Entity type:Individual
Prefix:MR
First Name:TYLER
Middle Name:CLAY
Last Name:SESNON
Suffix:
Gender:M
Credentials:MS, LPC, MHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 N GRAND AVE # 4
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-2606
Mailing Address - Country:US
Mailing Address - Phone:509-255-3935
Mailing Address - Fax:
Practice Address - Street 1:130 N GRAND AVE # 4
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-2606
Practice Address - Country:US
Practice Address - Phone:509-255-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61319387101YM0800X
IDLPC-8943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health