BROOKE LOUISE HASELTINE
NPI 1053954297
Psychologist in Arlington, VA

Active since October 21, 2019Opted out of Medicare · through Jun 30, 2027
4401 FAIRFAX DR STE 205, ARLINGTON, VA 22203(571) 328-7408 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 6, 2024, Aug 2, 2024, Oct 25, 2019 (3 updates tracked since 2019).

About Brooke Louise Haseltine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKE LOUISE HASELTINE (NPI 1053954297) is an individual psychologist in Arlington, Virginia, licensed in Virginia (0810008895) and active in the NPI registry since October 2019. She has opted out of Medicare through June 30, 2027.

NPPES Registry Identity

NPI1053954297
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameBROOKE LOUISE HASELTINE
Location Address4401 FAIRFAX DR STE 205Arlington, VA 22203-1622
Mailing Address4401 Fairfax Dr Ste 205Arlington, VA 22203-1622
Sole ProprietorNo
Enumeration DateOctober 21, 2019
Last NPPES UpdateApril 23, 20253 updates tracked since enumeration
NPPES CertifiedApril 23, 2025
NPI 1053954297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in VA · 0810008895
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselorTaxonomy 101Y00000X · License 009975 (NY)
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 0701008101 (VA)
4401 FAIRFAX DR STE 205, Arlington, VA 22203

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Brooke Louise Haseltine has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 30, 2025 through June 30, 2027.

Opt-Out Effective DateJune 30, 2025
Opt-Out In Effect ThroughJune 30, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Dietitian, Registered
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist (Clinical)
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist (Clinical)
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist (Clinical)
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203
Psychologist (Clinical)
4401 FAIRFAX DR STE 205
ARLINGTON, VA 22203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brooke Haseltine's NPI number?

The NPI number for Brooke Haseltine is 1053954297. It was assigned to this individual provider in the NPPES registry on October 21, 2019.

Where is Brooke Haseltine located?

Brooke Haseltine practices at 4401 Fairfax Dr Ste 205, Arlington, VA 22203. The listed phone number is (571) 328-7408.

What is Brooke Haseltine's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Brooke Haseltine enrolled in Medicare?

No. Brooke Haseltine has opted out of Medicare through June 30, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Brooke Haseltine was last updated on April 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.