TATIANA BERGSTROM (NPI# 1194325159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194325159 |
| Entity Type | Individual |
| Full Name | TATIANA BERGSTROM |
| Credential | LSATP |
| Practice Address |
5105q Backlick Rd Annandale VA 22003-6072 |
| Practice Telephone | 7035466474 |
| Practice Fax Number | 7032561596 |
| Mailing Telephone | 7035466474 |
| Mailing Fax Number | 7032561596 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0718000337 | VA | Behavioral Health & Social Service Providers |
| Street Address |
5105Q BACKLICK RD |
| City | ANNANDALE |
| State | VA |
| Zip Code | 22003-6072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194887042 | Harrison House, Inc. | Clinic/Center | 5105q Backlick Rd, Annandale, VA 22003-6005 | 2006-12-15 |
| 1184907537 | Monica Hayward | Exclusive Provider Organization | 5105q Backlick Rd, Annandale, VA 22003-6005 | 2011-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932741758 | Lien Hong Do | Pharmacist | 4014 Thornton Street, Annandale, VA 22003 | 2019-10-14 |
| 1639655376 | Brian D Blincoe | Military Health Care Provider | 7207 Masonville Drive, Annandale, VA 22003 | 2018-07-16 |
| 1790201481 | Mid Atlantic Plastic Surgeons LLC | Plastic Surgery | 3301 Woodburn Road, Suite 202, Annandale, VA 22003 | 2017-08-15 |
| 1053841668 | Rosalie Zuniga | Social Worker | 6800 Algonquin Court, Annandale, VA 22003 | 2017-06-15 |
| 1386179133 | Adaptive Care LLC | In Home Supportive Care | 4603 Logsdon Drive, Annandale, VA 22003 | 2017-04-28 |
| 1457808933 | Evergreen Foot and Ankle LLC | Podiatrist | 6928 Little River Turnpike, Suite B, Annandale, VA 22003 | 2016-09-01 |
| 1093165672 | Brightview Fairfax, LLC | Alzheimer Center (Dementia Center) | 3450 Gallows Road, Annandale, VA 22003 | 2016-06-15 |
| 1063867844 | Sports Care Acupuncture Clinic, LLC | Acupuncturist | 7535 Little River Tnpk #103a, Annandale, VA 22003 | 2016-04-28 |
| 1578925806 | Nu Dimensions, LLC | Day Training, Developmentally Disabled Services | 3602 Balin Ct, Annandale, VA 22003 | 2016-03-25 |
| 1932505641 | Julia Jiyoung Lee | Acupuncturist | 7535 Little River Tnpk, Suite 103a, Annandale, VA 22003 | 2014-11-06 |
| Find all providers in zip 22003 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306213855 | Sheila Graham | Counselor | 4659 Logsdon Dr, Annandale, VA 22003-3564 | 2015-08-31 |
| 1467705228 | Arlyn Elizabeth Marshall | Counselor | 3289 Woodburn Rd Ste 300, Annandale, VA 22003-7355 | 2012-10-18 |
| 1033449780 | Mark Hodkinson | Counselor | 2 Cheryle Way, Annandale, NJ 08801 | 2009-12-31 |
| 1619141512 | David A Errickson | Counselor | 1308 Route 31 N, Annandale, NJ 08801-3119 | 2008-04-22 |
| 1003330275 | Marietta Warden | Counselor | 4306 Evergreen Ln Ste 204, Annandale, VA 22003-3217 | 2017-07-31 |
| 1194275032 | Katrice Goff | Counselor | 3300 Woodburn Rd, Annandale, VA 22003-1202 | 2016-10-04 |
| 1083958052 | Nancy Knight Gordon | Counselor | 3289 Woodburn Rd Ste 300, Annandale, VA 22003-7355 | 2012-11-15 |
| 1790792653 | Susan Beardsley Gatsos | Counselor | 3340 Woodburn Rd, Annandale, VA 22003-1202 | 2006-08-02 |
| 1790791424 | Nancy Macleod | Counselor | 3340 Woodburn Rd, Annandale, VA 22003-1202 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457807 | Collaborative Point Counseling & Consulting | Counselor | 10509 Patterson Ave # 42302, Henrico, VA 23238-5103 | 2020-11-03 |
| 1558961441 | Savanna Martin | Counselor | 15105 Knickerbocker Dr, Woodbridge, VA 22193-1880 | 2020-10-29 |
| 1588264626 | Primary Addiction Treatment Center (p.a.t.) | Counselor | 525 Oyster Point Rd Ste D, Newport News, VA 23602-6014 | 2020-10-28 |
| 1881201275 | Harvest Care Counseling Center, LLC | Counselor | 12604 Prestonfield Dr, Chester, VA 23836-5856 | 2020-09-29 |
| 1588278311 | Abeba Fekade | Counselor | 2800 Eisenhower Ave Ste 210, Alexandria, VA 22314-4587 | 2020-08-31 |
| 1346858305 | Gwendolyn Daniels Slade | Counselor | 9 Canoe Ct, Portsmouth, VA 23703-5380 | 2020-07-16 |
| 1255949210 | Brian Jones | Counselor | 3322 Western Branch Blvd, Chesapeake, VA 23321-5142 | 2020-07-16 |
| 1346867058 | Kristin Fitzgerald | Counselor | 2320 Broad Rock Blvd, Richmond, VA 23224-4812 | 2020-06-29 |
| 1861019754 | Sandra Hill | Counselor | 6900 Mimms Dr, Chesterfield, VA 23832 | 2020-06-26 |
| 1699392571 | Tonya Elizabeth Goff | Counselor | 29 Hampshire Glen Pkwy, Hampton, VA 23669-4809 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.