Active NPI
Bianca Klein-Breteler
- Mental Health Counselor
- Chantilly, VA
National Provider Identifier
1972351088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0704012829
- Practice address
- 14117 Mariah CT
Chantilly, VA 20151-2113 - Phone
- (571) 520-2013
- NPI assigned
- May 13, 2024
- Last updated
- Jun 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0704012829 | VA | Primary |
Addresses
Primary practice location
14117 Mariah CT
Chantilly, VA 20151-2113
Mailing address
541 High St
Danville, VA 24541-1007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0704012829 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rule 62 Therapy LLC | Mental Health | Current | Accepting new patients |
Locations
14117 Mariah Ct
Chantilly, VA 20151
Phone (571) 210-0355
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": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1972351088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 HIGH ST",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245411007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14117 MARIAH CT",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201512113",
"telephone_number": "571-520-2013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN-BRETELER",
"first_name": "BIANCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-13",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "0704012829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.