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.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.