Organization
4 ROSES PSYCHOLOGICAL SERVICES. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA FERGUSON PH.D. (PRESIDENT & CEO)
(703) 705-7922
Entity
Organization
Contact information
Practice address
10300 BUSHMAN DR APT 309, OAKTON, VA 22124-2826
(312) 543-5107
Mailing address
2961A HUNTER MILL RD # 642, OAKTON, VA 22124-1704
(703) 705-2922
(703) 705-9336
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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