ANDREA MICHELLE BRUCKNER (NPI# 1396042974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396042974 |
| Entity Type | Individual |
| Full Name | ANDREA MICHELLE BRUCKNER |
| Credential | LPC |
| Practice Address |
3025 Hamaker Ct Ste 450 Fairfax VA 22031-2237 |
| Mailing Address |
200 Wood Hill Rd Rockville MD 20850-8724 |
| Practice Telephone | 7032049100 |
| Practice Fax Number | 3014681862 |
| Mailing Telephone | 3018384200 |
| Mailing Fax Number | 3014681862 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2019-10-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
0701008666 | VA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
72022793503 | UT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17214 Division St, Portland, OR 97236 | 5037615272 |
| Street Address |
3025 HAMAKER CT STE 450 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477164622 | Carolina Isabel Castedo | Counselor | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2020-08-12 |
| 1598399701 | Komal Bhutto | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2020-02-26 |
| 1932733136 | Caren Ann Appel | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2020-02-26 |
| 1295371417 | Maighdlin Terzaghi | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2019-11-22 |
| 1619533460 | Casey M Glassman | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2019-05-17 |
| 1912563024 | Sandy Miyamoto | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2019-05-14 |
| 1932668472 | Ida Damkilde | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2019-03-14 |
| 1861965709 | Maribel E Velez | Counselor | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2019-01-03 |
| 1346749207 | Melissa Zissman Golub | Social Worker | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2018-02-06 |
| 1154793735 | Jamie Kanter | Counselor | 3025 Hamaker Ct Ste 450, Fairfax, VA 22031-2237 | 2015-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161299 | Julie Embrey Bowman | Counselor | 3929 Old Lee Hwy Ste 92d, Fairfax, VA 22030-2421 | 2020-07-07 |
| 1588282685 | Keystone Therapy Group, LLC | Counselor | 10560 Main St Ste 511, Fairfax, VA 22030-7173 | 2020-07-06 |
| 1356977458 | Lauren Rivers | Counselor | 10650 Main St, Fairfax, VA 22030-3814 | 2020-03-20 |
| 1528694197 | Stephanie Renee Buchanan | Counselor | 8221 Willow Oaks Corporate Dr Ste 3-330k, Fairfax, VA 22031-4512 | 2020-03-16 |
| 1316579261 | Mari-elaine Triolo | Counselor | 8221 Willow Oaks Corporate Dr Ste 401, Fairfax, VA 22031-4512 | 2020-02-09 |
| 1902448251 | Fairfax Therapy Solutions LLC | Counselor | 9675 Main St Ste C, Fairfax, VA 22031-3762 | 2019-10-08 |
| 1790339513 | Lymaraina D'souza | Counselor | 3931 Tallow Tree Pl, Fairfax, VA 22033-2469 | 2019-07-30 |
| 1336709930 | Valerie Gayle Hadeed | Counselor | 3929 Old Lee Hwy Ste 92c, Fairfax, VA 22030-2421 | 2019-06-17 |
| 1487119707 | Abdelwahab Eltayeb Elsirag | Counselor | 12587 Fair Lakes Cir Ste 303, Fairfax, VA 22033-3822 | 2019-02-01 |
| 1558836825 | Monica Jongmin Lee | Counselor | 2850 Hideaway Rd, Fairfax, VA 22031-1331 | 2018-10-12 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.