Southeast Family Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SOUTHEAST FAMILY SERVICES, LLC

Practice address

3716 National Drive
Suite 124
Raleigh, NC 27612-4863

Phone

(919) 783-8846

NPI assigned

Jan 24, 2008

Organization subpart

No

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

Authorized official

Name

Nicole Caldwell, CCC/SLP

Title

Clinical Director/Owner

Phone

(919) 783-8846

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1710164454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 NATIONAL DRIVE",
            "address_2": "SUITE 124",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124863",
            "telephone_number": "919-783-8846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 NATIONAL DRIVE",
            "address_2": "SUITE 124",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124863",
            "telephone_number": "919-783-8846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "919-783-8846",
        "authorized_official_credential": "CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soul of a Woman
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• South Atlantic Speech, PLLC
• South Eastern Medical Suplies,Inc
• Southeast Family Services of Raleigh
• Southeast Primary Care, PLLC
• Southeastern Adult Day Center
• Southeastern Adult Day Center
• Southeastern Adult Day Center
• Southeastern Healthcare of North Carolina, Inc.

• Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.