Candee Lynn Bergstrom, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0904006409 Issued in VA

Practice address

8200 Ave. B
Fort Lee, VA 23801-1717

Phone

(804) 734-9143

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Fauquier Counseling Center

  • Counselor
  • Warrenton, VA
  • NPI 1528169430
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083703219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6848 BIXBY LN.",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "23838",
            "telephone_number": "804-590-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 AVE. B",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011717",
            "telephone_number": "804-734-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGSTROM",
        "first_name": "CANDEE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904006409",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C005383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becoming Whole Christian Wellness, PLLC
• John Patrick Benesek, PSY.D.
• Karen Inscoe Benglen, RN
• Velva C Bennett, NP
• Mary E. Bergman, PA-C
• Keith Neil Bishop, PT, SCS, ATC
• Vickie Bjorson
• Judy Kates Bland, RN
• Jane Elizabeth Blue, L.P.N
• June Bohrer, PNP

• Mental Health Counselor in Fort Lee, VA
• Providers in Fort Lee, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.