Individual provider Active NPI

Jacqueline L Bitanga, MA, LPC

  • Mental Health Counselor
  • Germantown, MD
National Provider Identifier
1831595842
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701008314 Issued in VA
Practice address
20400 Observation Dr Ste 103
Germantown, MD 20876-4086
Phone
(240) 686-1971
NPI assigned
Nov 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701008314 VA
Mental Health Counselor 101YM0800X 0701008314 VA Primary

Addresses

Primary practice location

20400 Observation Dr Ste 103
Germantown, MD 20876-4086

Mailing address

20400 Observation Dr Ste 103
Germantown, MD 20876-4086
Phone (240) 686-1971

Other practice location 1

19420 Golf Vista Plz Ste 250
Lansdowne, VA 20176-8267
Phone (804) 207-6737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240311000264 VA Practitioner - Mental Health Counselor 4486090644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Commonwealth Counseling Associates IncGroup PAC ID 0941288583, 207 clinicians

Practice addresses (Care Compare)

19420 Golf Vista PLZ
Suite 250
Lansdowne, VA 20176-8267
Phone (804) 207-6737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0701008314VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Counseling Associates Inc Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

19420 Golf Vista Plz
Ste 250
Leesburg, VA 20176
Phone (571) 349-0273

9202 Center Oak Ct
Mechanicsvlle, VA 23116
Phone (804) 639-1112

Interoperability endpoints

  • Direct secure messaging: granatogroup.jacquelinebitangacliento@144557.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1831595842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20400 OBSERVATION DR STE 103",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764086",
            "telephone_number": "240-686-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 OBSERVATION DR STE 103",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208764086",
            "telephone_number": "240-686-1971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19420 Golf Vista Plz Ste 250",
            "address_purpose": "LOCATION",
            "city": "Lansdowne",
            "state": "VA",
            "postal_code": "201768267",
            "country_code": "US",
            "telephone_number": "804-207-6737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BITANGA",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-18",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701008314",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701008314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

Verify at the official NPI Registry.