Individual provider Active NPI

Desrene V Sesay

  • Professional Counselor
  • Gaithersburg, MD
National Provider Identifier
1164179743
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC14829 Issued in MD
Practice address
20914 Merle Dr
Gaithersburg, MD 20882-1255
Phone
(240) 461-1054
NPI assigned
Mar 3, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X LGP12480 MD
Professional Counselor 101YP2500X LC14829 MD Primary

Addresses

Primary practice location

20914 Merle Dr
Gaithersburg, MD 20882-1255

Mailing address

20914 Merle Dr
Gaithersburg, MD 20882-1255
Phone (240) 461-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321001785 MD Practitioner - Mental Health Counselor 0941722656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

2100 Conowingo Rd
Bel Air, MD 21014-1824
Phone (410) 893-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP12480MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Behavioral Care, LLC Mental Health CurrentSince Mar 1, 2025 Accepting new patients
Uplift Behavioral Health PC Single Specialty Past Accepting new patients

Locations

1208 E Churchville Rd
Ste 300
Bel Air, MD 21014
Phone (410) 838-9500

2100 Conowingo Rd
Bel Air, MD 21014
Phone (410) 638-4170

3060 Mitchellville Rd
Ste 106B
Bowie, MD 20716
Phone (410) 838-9500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1164179743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20914 MERLE DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208821255",
            "telephone_number": "240-461-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20914 MERLE DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208821255",
            "telephone_number": "240-461-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESAY",
        "first_name": "DESRENE",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP12480",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.