DR. ANTONIA MARIE REPOLLET PSYD
NPI 1457968026
Psychologist in Burke, VA

Active since September 28, 2020Opted out of Medicare · through Oct 14, 2026
5244 LYNGATE CT STE 200, BURKE, VA 22015(703) 910-2577 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 10, 2024, Jun 13, 2024, Jun 19, 2023 and 3 more (6 updates tracked since 2020).

About Dr. Antonia Marie Repollet Psyd NPPES

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

DR. ANTONIA MARIE REPOLLET PSYD (NPI 1457968026) is an individual psychologist in Burke, Virginia, licensed in New Jersey (35SI00712100) and active in the NPI registry since September 2020. She has opted out of Medicare through October 14, 2026.

NPPES Registry Identity

NPI1457968026
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. ANTONIA MARIE REPOLLETCredential: PSYD
Location Address5244 LYNGATE CT STE 200Burke, VA 22015-1631
Mailing Address5244 Lyngate Ct Ste 200Burke, VA 22015-1631 · (703) 910-2577
Sole ProprietorNo
Enumeration DateSeptember 28, 2020
Last NPPES UpdateSeptember 10, 20246 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2024
NPI 1457968026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in NJ · 35SI00712100 Licensed in NY · 025710 Licensed in MT · PSY-PSY-LIC-5083
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 ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 0810008547 (VA)
Also ListedPsychologist · SchoolTaxonomy 103TS0200X · License 1027950 (NJ)
5244 LYNGATE CT STE 200, Burke, VA 22015

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Antonia Marie Repollet Psyd 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 October 14, 2024 through October 14, 2026.

Opt-Out Effective DateOctober 14, 2024
Opt-Out In Effect ThroughOctober 14, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 11

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

Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Clinical)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Counselor (Professional)
5244 LYNGATE CT STE 200
BURKE, VA 22015
Psychologist (Cognitive & Behavioral)
5244 LYNGATE CT STE 200
BURKE, VA 22015

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 Antonia Repollet's NPI number?

The NPI number for Antonia Repollet is 1457968026. It was assigned to this individual provider in the NPPES registry on September 28, 2020.

Where is Antonia Repollet located?

Antonia Repollet practices at 5244 Lyngate Ct Ste 200, Burke, VA 22015. The listed phone number is (703) 910-2577.

What is Antonia Repollet's specialty?

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

Is Antonia Repollet enrolled in Medicare?

No. Antonia Repollet has opted out of Medicare through October 14, 2026. 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 Antonia Repollet was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.