Individual
DR. JAMES ETHAN FAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., M.ED.
Contact information
Practice address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 307-4907
Mailing address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(571) 307-4907
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810009233
VA
Other
Enumeration date
02/23/2026
Last updated
02/23/2026
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