Provider Demographics
NPI:1699588822
Name:CHANDRA, MONISHA (PSYD)
Entity type:Individual
Prefix:
First Name:MONISHA
Middle Name:
Last Name:CHANDRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 HIGHLAND BLF
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-2878
Mailing Address - Country:US
Mailing Address - Phone:205-454-9270
Mailing Address - Fax:205-454-9270
Practice Address - Street 1:1041 CAMBRIDGE SQ STE A
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1871
Practice Address - Country:US
Practice Address - Phone:770-361-7864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004853103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical