Provider Demographics
NPI:1861287245
Name:SESSOMS, GREYLAN BROOKE (LCMHCA)
Entity type:Individual
Prefix:
First Name:GREYLAN
Middle Name:BROOKE
Last Name:SESSOMS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 CLOUD MIST CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6630
Mailing Address - Country:US
Mailing Address - Phone:919-210-8371
Mailing Address - Fax:
Practice Address - Street 1:1764 HERITAGE CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4092
Practice Address - Country:US
Practice Address - Phone:984-235-7596
Practice Address - Fax:984-235-7054
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
NCA212191101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional