Provider Demographics
NPI:1457653628
Name:PSYCH SUPPORT INC.
Entity Type:Organization
Organization Name:PSYCH SUPPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-850-3480
Mailing Address - Street 1:211 E SIX FORKS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7743
Mailing Address - Country:US
Mailing Address - Phone:919-850-3480
Mailing Address - Fax:
Practice Address - Street 1:211 E SIX FORKS RD STE 108
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7743
Practice Address - Country:US
Practice Address - Phone:919-850-3480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health