Healthcare Provider Details

I. General information

NPI: 1982522157
Provider Name (Legal Business Name): ENLIGHTENED HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10119 LOMOND DR
MANASSAS VA
20109
US

IV. Provider business mailing address

9890 LIBERIA AVE 1162
MANASSAS VA
20110
US

V. Phone/Fax

Practice location:
  • Phone: 703-282-2821
  • Fax: 703-361-9759
Mailing address:
  • Phone: 703-282-2821
  • Fax: 703-361-9759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. RENE L ERNEST
Title or Position: ADVANCED PRACTICE NP
Credential: PMHNP-BC
Phone: 703-282-2821