Individual provider Active NPI

Brett L Opelt, PHD

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1639798598
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
07641 Issued in MD
Practice address
1241 W Jackson Blvd Unit 310
Chicago, IL 60607-2858
Phone
(414) 416-5732
NPI assigned
Apr 10, 2020
Reactivated
Apr 22, 2024
Last updated
Jun 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6477-125 WI
Clinical Psychologist 103TC0700X 071022563 IL
Clinical Psychologist 103TC0700X 07641 MD Primary

Addresses

Primary practice location

1241 W Jackson Blvd Unit 310
Chicago, IL 60607-2858

Mailing address

1241 W Jackson Blvd Unit 310
Chicago, IL 60607-2858
Phone (414) 416-5732

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251216001094 DC Practitioner - Clinical Psychologist 0840784997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6477-125WIMDMental Health Counselor
071022563ILMDClinical Psychologist
07641MDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 18, 2025 Accepting new patients

Locations

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1639798598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W JACKSON BLVD UNIT 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072858",
            "telephone_number": "414-416-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 W JACKSON BLVD UNIT 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072858",
            "telephone_number": "414-416-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPELT",
        "first_name": "BRETT",
        "middle_name": "L",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "deactivation_date": "2022-07-11",
        "reactivation_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6477-125",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071022563",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "07641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.