# OBOSE BEHAVIORAL HEALTH & WELLNESS CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Obose Mental Health Clinic LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154168102
- **Authorized official:** DR. ROSE AKHOASEGBE EHICHIOYA PMH-NP (OWNER)
- **Authorized official phone:** (703) 973-0176

## Contact information

- **Practice address:** 3130 GOLANSKY BLVD STE 201, WOODBRIDGE, VA 22192-4268
- **Practice address phone:** (703) 973-0176
- **Practice address fax:** (571) 428-2027
- **Mailing address:** 3130 GOLANSKY BLVD STE 201, WOODBRIDGE, VA 22192-4268
- **Mailing address phone:** (703) 973-0176
- **Mailing address fax:** (571) 428-5076

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2024
- **Last updated:** 10/03/2026