4 Roses Psychological Services. PLLC

Organization Active NPI Adult Mental Health Clinic/Center · Oakton, VA

NPI 1356065486 · NPPES record last updated Oct 3, 2022

Key facts

NPI: 1356065486
Entity type: Organization (NPI type 2)
Primary specialty: Adult Mental Health Clinic/Center 261QM0850X
Legal business name: 4 ROSES PSYCHOLOGICAL SERVICES. PLLC
Practice address: 10300 Bushman Dr Apt 309
Oakton, VA 22124-2826
Phone: (312) 543-5107
NPI assigned: Oct 3, 2022
Organization subpart: No

Authorized official

Name: Dr. Debra Ferguson, PH.D. NPI 1679921043
Title: President & Ceo
Phone: (703) 705-7922

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Debra Ferguson, PH.D. Clinical Psychologist · Oakton, VA · NPI 1679921043

Medicare reassignment NPD Authorized official DC

Medicare participation

Medicare fee-for-service enrollment: Enrolled in DC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20221024000184	DC	Part B Supplier - Clinic/Group Practice	4880060458	Receives reassigned benefits from 1 practitioner Practice locations: Oakton, VA

National Provider Directory

Locations

2961A Hunter Mill Rd
Oakton, VA 22124
Phone (703) 914-3237

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X
Adult Mental Health Clinic/Center	261QM0850X	Yes
Adolescent and Children Mental Health Clinic/Center	261QM0855X

Addresses

Primary practice location

10300 Bushman Dr Apt 309
Oakton, VA 22124-2826

Mailing address

2961A Hunter Mill Rd # 642
Oakton, VA 22124-1704
Phone (703) 705-2922

Other providers in Oakton, VA

All providers in Oakton, VA · Adult Mental Health Clinic/Center in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.