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
Phone: (703) 792-7800
Fax: (703) 792-5699
Website:
Health care specialties
| Specialty | Code | License # | 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 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891842704 | NPPES |
| Virginia | Other | 210247 | BLUE CROSS BLUE SHIELD |
| Virginia | MEDICAID | 4945247 | BLUE CROSS BLUE SHIELD |
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