Provider Demographics
NPI:1164882122
Name:SHARMA, SANDHYA (LPC, CACII)
Entity Type:Individual
Prefix:MS
First Name:SANDHYA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:LPC, CACII
Other - Prefix:MS
Other - First Name:SANDHYA
Other - Middle Name:
Other - Last Name:NAGABHUSHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGPC CAC II
Mailing Address - Street 1:10474 ARMSTRONG ST STE 207
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3648
Mailing Address - Country:US
Mailing Address - Phone:703-595-2662
Mailing Address - Fax:
Practice Address - Street 1:10474 ARMSTRONG ST STE 207
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3648
Practice Address - Country:US
Practice Address - Phone:703-595-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-03
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC14895101YA0400X
DCLPC00042101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPRC14895OtherLICENSED PROFESSIONAL COUNSELOR