Brooke Louise Haseltine

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0810008895 Issued in VA

Practice address

4401 Fairfax Dr Ste 205
Arlington, VA 22203-1622

Phone

(571) 328-7408

NPI assigned

Oct 21, 2019

Last updated

Apr 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 30, 2025 through Jun 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mind Body Health LLC

  • Psychologist
  • Arlington, VA
  • NPI 1427527043
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1053954297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 FAIRFAX DR STE 205",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 FAIRFAX DR STE 205",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222031622",
            "telephone_number": "571-328-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASELTINE",
        "first_name": "BROOKE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "009975",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701008101",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Jessica Hart, FNP-C, CSCS
• Jacquelyn Renee Hart
• Alyssa Hartman, DDS
• Kate-Alden G. Hartman, CRNA
• Fadi Hasan, DDS
• Nabila Hassan, LPC, NCC, CAADC
• Roshanak Hassanzadeh, OTD
• Roza H Hassen, MD
• Ann Casey Hassett
• Tiffani Hastings, PT, DPT

• Psychologist in Arlington, VA
• Providers in Arlington, VA by specialty
• Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.