TATIANA L BERGSTROM MA, LSATP
NPI 1194325159
Counselor - Addiction (Substance Use Disorder) in Woodbridge, VA

Q: What is Tatiana Bergstrom's NPI number?

The NPI number for Tatiana Bergstrom is 1194325159. It was assigned to this individual provider in the NPPES registry on October 29, 2020.

Q: What is Tatiana Bergstrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Tatiana Bergstrom was last updated on September 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 29, 2020PECOS Enrolled

4001 PRINCE WILLIAM PKWY STE 301, WOODBRIDGE, VA 22192(703) 688-8541(703) 213-5025 Get Directions Write a Review

NPPES record last updated: September 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 20, 2024, Oct 29, 2020 (2 updates tracked since 2020).

On this page

About Tatiana L Bergstrom Ma, Lsatp NPPES

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

TATIANA L BERGSTROM MA, LSATP (NPI 1194325159) is an individual addiction (substance use disorder) provider in Woodbridge, Virginia, licensed in Virginia (0718000337) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194325159

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameTATIANA L BERGSTROMCredential: MA, LSATP

Location Address4001 PRINCE WILLIAM PKWY STE 301Woodbridge, VA 22192-7667

Mailing Address4001 Prince William Pkwy Ste 301Woodbridge, VA 22192-7667 · (703) 688-8541 · Fax (703) 213-5025

Phone(703) 688-8541

Fax(703) 213-5025

Sole ProprietorYes

Enumeration DateOctober 29, 2020

Last NPPES UpdateSeptember 20, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 20, 2024

✔ NPI 1194325159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in VA · 0718000337

4001 PRINCE WILLIAM PKWY STE 301, Woodbridge, VA 22192

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tatiana L Bergstrom Ma, Lsatp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

KATHLEEN ELIZABETH BURCH

Social Worker (Clinical)