Provider Demographics
NPI:1699342865
Name:SASTRY, AISHWARYA MANJUNATH (LMHC)
Entity type:Individual
Prefix:
First Name:AISHWARYA MANJUNATH
Middle Name:
Last Name:SASTRY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3622 22ND AVE W APT A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-9801
Mailing Address - Country:US
Mailing Address - Phone:613-891-5977
Mailing Address - Fax:
Practice Address - Street 1:3622 22ND AVE W APT A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98199-9801
Practice Address - Country:US
Practice Address - Phone:425-954-5759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist