Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
PRIMARY SOURCE GROUP, PLLC
Active
Organization
PRIMARY SOURCE GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE M HARDY MSW, LCSW, CSS (PRESIDENT/OWNER)
(919) 434-3555
Entity
Organization
Contact information
Practice address
4905 GREEN RD, SUITE 105, RALEIGH, NC 27616-2805
(919) 981-7373
(919) 981-7373
Mailing address
PO BOX 58098, RALEIGH, NC 27658-8098
(919) 434-3555
(919) 981-7373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1222
NC
103T00000X
Psychologist
1572
NC
103TC1900X
Counseling Psychologist
865
NC
1041C0700X
Clinical Social Worker
Primary
C003663
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6106329
—
NC
Enumeration date
06/08/2009
Last updated
07/25/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up