Provider Demographics
NPI:1457479644
Name:SESTERO, KELLY KATHLEEN (LPC, LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:KATHLEEN
Last Name:SESTERO
Suffix:
Gender:F
Credentials:LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12725 SW MILLIKAN WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1687
Mailing Address - Country:US
Mailing Address - Phone:503-208-6511
Mailing Address - Fax:971-329-4700
Practice Address - Street 1:12725 SW MILLIKAN WAY STE 300
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1687
Practice Address - Country:US
Practice Address - Phone:503-208-6511
Practice Address - Fax:971-329-4700
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAL00008871101YM0800X
ORC6634101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health