NPIMap

Organization Active NPI

Psych Support Inc.

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1699812651
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PSYCH SUPPORT INC.
Practice address
211 E Six Forks Rd
BLDG. C Suite 108
Raleigh, NC 27609-7745
Phone
(919) 850-3480
Fax
(919) 899-6330
NPI assigned
Jan 31, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Golding, M.D.
Title
Owner
Phone
(919) 850-3480

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

211 E Six Forks Rd
BLDG. C Suite 108
Raleigh, NC 27609-7745

Mailing address

211 E Six Forks Rd
BLDG. C Suite 108
Raleigh, NC 27609-7745
Phone (919) 850-3480

Other identifiers 4

IdentifierTypeStateIssuer
89016N3MedicaidNC
8301505MedicaidNC
8301505GMedicaidNC
6005068MedicaidNC

National Provider Directory

National Provider Directory

Locations

401 Hillsborough St
Raleigh, NC 27603
Phone (919) 821-0790

2404 Montgomery Dr SW
Ste E
Wilson, NC 27893
Phone (252) 234-2008

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1699812651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "BLDG. C SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-850-3480",
            "fax_number": "919-899-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E SIX FORKS RD",
            "address_2": "BLDG. C SUITE 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097745",
            "telephone_number": "919-850-3480",
            "fax_number": "919-899-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH SUPPORT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "GOLDING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-850-3480",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016N3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301505",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301505G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005068",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.