Individual provider Active NPI

Bonita Irene Becker, PH.D.

  • Clinical Psychologist
  • McLean, VA
National Provider Identifier
1962549949
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Practice address
1499 Chain Bridge Rd
Suite 200
McLean, VA 22101-5704
Phone
(703) 821-6858
Fax
(703) 578-3358
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X VA Primary

Addresses

Primary practice location

1499 Chain Bridge Rd
Suite 200
McLean, VA 22101-5704

Mailing address

1499 Chain Bridge Rd
Suite 200
McLean, VA 22101-5704
Phone (703) 821-6858

Other identifiers 2

IdentifierTypeStateIssuer
6431OtherVACAREFIRST BCBS
227945OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
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.
Opted out of Medicare
Yes, effective Apr 1, 2015 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
081000345VAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962549949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 CHAIN BRIDGE RD",
            "address_2": "SUITE 200",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221015704",
            "telephone_number": "703-821-6858",
            "fax_number": "703-578-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 CHAIN BRIDGE RD",
            "address_2": "SUITE 200",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221015704",
            "telephone_number": "703-821-6858",
            "fax_number": "703-578-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "BONITA",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "6431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "227945",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.