Primary Source Group, Pllc is a Psychology Clinic in Raleigh, North Carolina. It is located at 4905 Green Rd, Suite 105, Raleigh, NC and its contact number is 919-981-7373. The authorized person for Primary Source Group, Pllc is Leslie M Hardy
who is President/owner of the clinic and his/her contact number is 919-434-3555. The primary license number for Primary Source Group, Pllc is C003663 (Clinical) in North Carolina. Primary Source Group, Pllc Clinic is specialized in psychological testing and evaluating or assessing patient's personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning. Accordingly, psychologists performs counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy. Psychologists can diagnose and treat mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability by psycheducational evaluation, therapy, remediation, and consultation.
Complete Clinic Profile:
Primary Source Group, Pllc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Primary Source Group, Pllc
Specialization:
Psychology
Clinic Address:
4905 Green Rd, Suite 105, Raleigh, North Carolina, 27616-2805
Phone:
919-981-7373
Fax:
919-981-7373
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Leslie M Hardy
Position:
President/owner
Contact Number:
919-434-3555
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Primary Source Group, Pllc clinic are as mentioned below.
NPI Number:
1104052901
NPI Enumeration Date:
08 Jun, 2009
NPI Last Update On:
25 Jul, 2011
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Primary Source Group, Pllc are as mentioned below.
Specialization
License Number
State
Status
Clinical
C003663
North Carolina
Primary
Addiction (Substance Use Disorder)
1222
North Carolina
Secondary
Psychologist
1572
North Carolina
Secondary
Counseling
865
North Carolina
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
6106329
Medicaid
North Carolina
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Primary Source Group, Pllc Po Box 58098, Raleigh, North Carolina
Zip:
27658-8098
Phone Number:
919-434-3555
Fax Number:
919-981-7373
Patients can reach Primary Source Group, Pllc at 4905 Green Rd, Suite 105, Raleigh, North Carolina or can call to book an appointment on 919-981-7373. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 09 December, 2024.