PRIMARY SOURCE GROUP, PLLC
NPI 1104052901
Social Worker - Clinical in Raleigh, NC

Active since June 08, 2009
4905 GREEN RD, SUITE 105, RALEIGH, NC 27616(919) 981-7373(919) 981-7373 Get Directions Write a Review

NPPES record last updated: July 25, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Primary Source Group, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMARY SOURCE GROUP, PLLC (NPI 1104052901) is a healthcare organization registered as a clinical in Raleigh, North Carolina and active in the NPI registry since June 2009. The organization lists Leslie M Hardy, President/owner, as its authorized official.

NPPES Registry Identity

NPI1104052901
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NamePRIMARY SOURCE GROUP, PLLC
Location Address4905 GREEN RD, SUITE 105Raleigh, NC 27616-2805
Mailing AddressPo Box 58098Raleigh, NC 27658-8098 · (919) 434-3555 · Fax (919) 981-7373
Fax(919) 981-7373
Organization SubpartNo
Authorized OfficialLeslie M HardyPresident/owner · (919) 434-3555
Enumeration DateJune 8, 2009
Last NPPES UpdateJuly 25, 2011
NPI 1104052901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in NC · C003663
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 1222 (NC)
Also ListedPsychologistTaxonomy 103T00000X · License 1572 (NC)
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 865 (NC)
4905 GREEN RD, Raleigh, NC 27616

Other Identifiers 1

Medicaid6106329NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
4905 GREEN RD, SUITE 107B
RALEIGH, NC 27616
Family Medicine
4905 GREEN RD, STE 100
RALEIGH, NC 27616
Social Worker (Clinical)
4905 GREEN RD, SUITE 105
RALEIGH, NC 27616
Dentist (General Practice)
4905 GREEN RD, 111
RALEIGH, NC 27616
Dentist (General Practice)
4905 GREEN RD, SUITE 111
RALEIGH, NC 27616
Physician Assistant
4905 GREEN RD, STE. 100
RALEIGH, NC 27616

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Primary Source Group, PLLC's NPI number?

The NPI number for Primary Source Group, PLLC is 1104052901. It was assigned to this organization in the NPPES registry on June 8, 2009.

Where is Primary Source Group, PLLC located?

Primary Source Group, PLLC is located at 4905 Green Rd Suite 105, Raleigh, NC 27616. The listed phone number is (919) 981-7373.

What is Primary Source Group, PLLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Primary Source Group, PLLC was last updated on July 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.