Healthcare Provider Details

I. General information

NPI: 1982521506
Provider Name (Legal Business Name): SANDY GASPER LCP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 S FREDERICK ST
ARLINGTON VA
22204-3326
US

IV. Provider business mailing address

1203 S FREDERICK ST
ARLINGTON VA
22204-3326
US

V. Phone/Fax

Practice location:
  • Phone: 202-607-3773
  • Fax:
Mailing address:
  • Phone: 202-607-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009429
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: