Healthcare Provider Details

I. General information

NPI: 1336238864
Provider Name (Legal Business Name): DOMINION HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 W MILLBROOK RD
RALEIGH NC
27609-4304
US

IV. Provider business mailing address

608 PENDLETON LAKE RD
RALEIGH NC
27614-9093
US

V. Phone/Fax

Practice location:
  • Phone: 919-676-4714
  • Fax: 919-676-4715
Mailing address:
  • Phone: 919-676-4714
  • Fax: 919-676-4715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL W HOPKINS SR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 919-676-4714