Gayatri Sneh Mantha, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0805002487 Issued in VA

Practice address

24600 Millstream Dr Ste 340
Stone Ridge, VA 20105-5686

Phone

(703) 327-0335

NPI assigned

Sep 11, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1104603422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 JETSTREAM RD",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201712576",
            "telephone_number": "703-554-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24600 MILLSTREAM DR STE 340",
            "city": "STONE RIDGE",
            "state": "VA",
            "postal_code": "201055686",
            "telephone_number": "703-327-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTHA",
        "first_name": "GAYATRI",
        "middle_name": "SNEH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0805002487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Marie Jaffe, O.D.
• Margaret Kahn, LCSW
• Mi Kim
• Michael Kim, OD
• Erin Kathren Long, P.T., D.P.T
• Jennifer M McCormick, OTR
• Susan McCarty McCormick, MS, LMFT
• Med Urgent Care LLC
• Susanna Kay Meyer, PHARMD
• Chris Moon, PT

• Clinical Psychologist in Stone Ridge, VA
• Providers in Stone Ridge, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.