Provider Demographics
NPI:1710398748
Name:BESSETTE, SARA NICOLE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:NICOLE
Last Name:BESSETTE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 TURIN ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-3315
Mailing Address - Country:US
Mailing Address - Phone:214-315-7150
Mailing Address - Fax:
Practice Address - Street 1:143 W DOMINICK ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5857
Practice Address - Country:US
Practice Address - Phone:315-677-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010636101YM0800X
NY100532-01101YM0800X
171M00000X
TX222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist