Provider Demographics
NPI:1184819054
Name:THE GOOD SAMARITAN COUNSELING, PA
Entity Type:Organization
Organization Name:THE GOOD SAMARITAN COUNSELING, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:DILLON
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-358-8634
Mailing Address - Street 1:8360 SIX FORKS RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5077
Mailing Address - Country:US
Mailing Address - Phone:919-358-8634
Mailing Address - Fax:
Practice Address - Street 1:11725 BROADFIELD CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-4255
Practice Address - Country:US
Practice Address - Phone:919-358-8634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-012132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty