My Psychiatrist LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Reston, VA
NPI 1295048684 · NPPES record last updated Dec 18, 2024
Key facts
- NPI
- 1295048684
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- MY PSYCHIATRIST LLC
- Practice address
- 12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463 - Phone
- (703) 596-4796
- NPI assigned
- Jul 14, 2010
- Organization subpart
- No
Authorized official
- Name
- Madan Uprety
- Title
- Ceo
- Phone
- (703) 596-4796
Practitioners 33
-
Heidi Anna Cook, MA, MSN,PMHNP-BC
-
Connie Lynn Jenks, LPC
-
Jeffrey Martens, PH.D.
-
Kathleen Reindl Martens, PSYD
-
Joshua Niekranz, PMHNP-BC
-
Brian Tran, PMHNP-BC
-
Madan Uprety, M.D.
-
Sanju Adhikari, MD
-
Paul J Bennett, LCSW
-
Jennifer Chow, MD
-
Rachel Suk, RN, PMHNP-BC
-
John W Getz, PSY.D.
-
Michele L Gunter, LCSW
-
Shanya Hardie, PMHNP
-
Tae Kyung Kim, PMHNP
-
Imani McGlen, LCSW
-
Wooni F Kim, PMHNP
-
Michael Walsh, CT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100805000650 | DC | Part B Supplier - Clinic/Group Practice | 5597898981 |
Receives reassigned benefits from 21 practitioners Practice locations: Reston, VA; Falls Church, VA |
| O20140616000128 | VA | Part B Supplier - Clinic/Group Practice | 5597898981 |
Receives reassigned benefits from 4 practitioners Practice locations: Gainesville, VA; Manassas, VA |
National Provider Directory
Locations
6565 Arlington Blvd
Ste 405
Falls Church, VA 22042
Phone (571) 946-2189
7001 Heritage Village Plz
Ste 240
Gainesville, VA 20155
Phone (571) 248-9933
12359 Sunrise Valley Dr
#32
Reston, VA 20191
Phone (703) 596-4796
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | |||
| Child & Adolescent Psychiatry Physician |
2084P0804X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Mailing address
12359 Sunrise Valley Dr Ste 320
Reston, VA 20191-3463
Phone (703) 596-4796
Other practice location 1
6565 Arlington Blvd Ste 405
Falls Church, VA 22042-3000
Phone (703) 596-4796
Other names
- My Psychiatrist PLC
Other providers in Reston, VA
- Tirest Mulugeta
- Michaela Mulvey
- Amy M Murdock
- Renata Murphy
- Nicholas Adrian Muss
- My Psychiatrist Reston, PLC
- Lance Myers
- Myeyedr Optometry of Virginia, PLLC
- Wayne Scott Myles
- Nadder M Hassan DDS
All providers in Reston, VA · Mental Health Clinic/Center (Including Community Mental Health Center) in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.