James Ethan Fayne, PSY.D., M.ED.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810009233 Issued in VA

Practice address

10432 Balls Ford Rd Ste 300
Manassas, VA 20109-2517

Phone

(571) 307-4907

NPI assigned

Feb 23, 2026

Last updated

Feb 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1417801069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10432 BALLS FORD RD STE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092517",
            "telephone_number": "571-307-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10432 BALLS FORD RD STE 300",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201092517",
            "telephone_number": "571-307-4907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10908 Courthouse Rd",
            "address_purpose": "LOCATION",
            "city": "Fredericksburg",
            "state": "VA",
            "postal_code": "224082658",
            "country_code": "US",
            "telephone_number": "540-645-2458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAYNE",
        "first_name": "JAMES",
        "middle_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810009233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Manassas, VA
• Providers in Manassas, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.