| 4 Roses Psychological Services. Pllc | |
|
10300 Bushman Dr Apt 309 Oakton VA 22124-2826 | |
| (312) 543-5107 | |
| Not Available |
| Full Name | 4 Roses Psychological Services. Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10300 Bushman Dr Apt 309, Oakton, Virginia |
| Authorized Official Name and Position | Debra Ferguson (PRESIDENT & CEO) |
| Authorized Official Contact | 7037057922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 Roses Psychological Services. Pllc 2961a Hunter Mill Rd # 642 Oakton VA 22124-1704 Ph: (703) 705-2922 | 4 Roses Psychological Services. Pllc 10300 Bushman Dr Apt 309 Oakton VA 22124-2826 Ph: (312) 543-5107 |
| NPI Number | 1356065486 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Medicare PECOS PAC ID | 4880060458 |
|---|---|
| Medicare Enrollment ID | O20221024000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356065486 | NPI | - | NPPES |
| Provider Name | Debra K Ferguson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679921043 PECOS PAC ID: 4880973874 Enrollment ID: I20161115001519 |
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