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General NPI Number Information
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NPI Number | 1255115481
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Entity Type | Organization
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Legal Business Name | R4 ENTERPRISE LLC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 39344 LITTLE RIVER TPKE STE 346
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City | ALDIE
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State | VA
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Zip | 20105-2000
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Country | US
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Telephone | 703-375-9396
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Fax |
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Provider Business Mailing Address
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Address Line | 39344 JOHN MOSBY HWY STE 346
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City | ALDIE
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State | VA
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Zip | 20105-2000
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Country | US
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Telephone | 703-375-9396
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | ASHLEY RUSHING
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Credential | LPC
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Telephone | 703-728-6599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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