MEDICARE: PRIME CARE SUPPORT SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1558216960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE SUPPORT SERVICES, PLLC

Provider Business Mailing Address
First Line	:	613 BON AIR AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-3301
Country	:	US
Telephone Number	:	919-914-3828
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 BON AIR AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-3301
Country	:	US
Telephone Number	:	919-914-3828
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SHAREE JONES
Credential	:	LCSW, LCASA
Telephone Number	:	919-914-3828

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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