Primary Source Group, Pllc
LBN: Primary Source Group, Pllc
Primary Source Group, Pllc is an health care organization with primary practice located at 4905 Green Rd Suite 105, Raleigh NC 27616-2805. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty.
Primary Source Group, Pllc can be contacted via phone (919) 981-7373, or through Hardy, Leslie M via phone (919) 434-3555.
Contact Information
Primary practice address
4905 Green Rd Suite 105
Raleigh NC 27616-2805
Phone: (919) 981-7373
Fax: (919) 981-7373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1222 | North Carolina |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1572 | North Carolina |
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 865 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C003663 | North Carolina |
Profile Details
| NPI number | 1104052901 |
|---|---|
| LBN Legal business name | Primary Source Group, Pllc |
| DBA Doing business as | |
| Authorized official | Hardy, Leslie M MSW, LCSW, CSS |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 8th, 2009 |
| Last updated | Jul 25th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104052901 | NPPES |
| North Carolina | MEDICAID | 6106329 |
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