Active NPI
Rose Akhoasegbe Ehichioya, PMHNP, PHD
- Psychiatric/Mental Health Nurse Practitioner
- Woodbridge, VA
National Provider Identifier
1649960410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 0024187059
- Practice address
- 3130 Golansky Blvd Ste 201
Woodbridge, VA 22192-4268 - Phone
- (703) 973-0176
- Fax
- (571) 428-2027
- NPI assigned
- May 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024187059 | VA | Primary |
Addresses
Primary practice location
3130 Golansky Blvd Ste 201
Woodbridge, VA 22192-4268
Mailing address
3130 Golansky Blvd Ste 201
Woodbridge, VA 22192-4268
Phone (571) 899-5076
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250321002802 | VA | Practitioner - Nurse Practitioner | 4385164300 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024187059 | VA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Destiny Connection LLC | Current | Accepting new patients | |
| Obose Behavioral Health & Wellness Clinic LLC | Multi-Specialty | Current | Accepting new patients |
| Excellent Care Home Health Services LLC | Current | Accepting new patients |
Locations
3130 Golansky Blvd
Ste 201
Woodbridge, VA 22192
Phone (703) 973-0176
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Woodbridge, VA
- NPI 1306661657
-
- Home Health Agency
- Woodbridge, VA
- NPI 1568820603
-
- Psychiatric/Mental Health Nurse Practitioner
- Woodbridge, VA
- NPI 1154168102
Multi-Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783296000000",
"number": "1649960410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3130 GOLANSKY BLVD STE 201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924268",
"telephone_number": "571-899-5076",
"fax_number": "571-428-2027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 GOLANSKY BLVD STE 201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924268",
"telephone_number": "703-973-0176",
"fax_number": "571-428-2027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHICHIOYA",
"first_name": "ROSE",
"middle_name": "AKHOASEGBE",
"name_prefix": "Dr.",
"credential": "PMHNP, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-15",
"last_updated": "2026-07-06",
"certification_date": "2026-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "VA",
"license": "0024187059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.