Bush, Alicia R

Bush, Alicia R is an sole proprietor health care provider with primary practice located at 7969 Ashton Ave , Manassas VA 20109-2885. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bush, Alicia R can be contacted via phone (703) 792-7800.

Contact Information

Primary practice address
7969 Ashton Ave Manassas VA 20109-2885
Fax: (703) 792-5699
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0904000876 Virginia

Profile Details

NPI number 1891842704
LBN Legal business name Bush, Alicia R
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891842704 NPPES
Virginia Other 210247 BLUE CROSS BLUE SHIELD
Virginia MEDICAID 4945247 BLUE CROSS BLUE SHIELD

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