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General NPI Number Information
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NPI Number | 1699812651
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Entity Type | Organization
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Legal Business Name | PSYCH SUPPORT INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 211 E SIX FORKS RD BLDG. C SUITE 108
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City | RALEIGH
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State | NC
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Zip | 27609-7745
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Country | US
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Telephone | 919-850-3480
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Fax | 919-899-6330
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Provider Business Mailing Address
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Address Line | 211 E SIX FORKS RD BLDG. C SUITE 108
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City | RALEIGH
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State | NC
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Zip | 27609-7745
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Country | US
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Telephone | 919-850-3480
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Fax | 919-899-6330
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL GOLDING
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Credential | M.D.
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Telephone | 919-850-3480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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