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LIFESOURCE OF NORTH CAROLINA
NPI 1114419124
Social Worker - Clinical in Richmond, VA

Active since June 05, 2018
1901 LIBBIE AVE, RICHMOND, VA 23226(910) 742-9243(888) 746-1787 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 25, 2021, Sep 21, 2018 (2 updates tracked since 2018).

About Lifesource Of North Carolina NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFESOURCE OF NORTH CAROLINA (NPI 1114419124) is a healthcare organization registered as a clinical in Richmond, Virginia and active in the NPI registry since June 2018. The organization maintains a secondary practice location in Glen Allen and lists Peggy Baddour, President/owner, as its authorized official.

NPPES Registry Identity

NPI1114419124
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLIFESOURCE OF NORTH CAROLINA
Location Address1901 LIBBIE AVERichmond, VA 23226-1808
Mailing AddressPo Box 538622Atlanta, GA 30353-8622 · (910) 742-9243
Phone(910) 742-9243
Fax(888) 746-1787
Organization SubpartNo
Authorized OfficialPeggy BaddourPresident/owner · (910) 777-9165
Enumeration DateJune 5, 2018
Last NPPES UpdateMarch 25, 20212 updates tracked since enumeration
NPPES CertifiedMarch 25, 2021
✔ NPI 1114419124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1901 LIBBIE AVE, Richmond, VA 23226
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Secondary Practice Location 1

Location 110307 W Broad St., #309Glen Allen, VA 23060-6716 · Phone (910) 742-9243

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lifesource Of North Carolina is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Lifesource Of North Carolina, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Terrie Pendleton, LCSW
Clinical Social Worker
NPI 1639262132
5002 MONUMENT AVE STE 201
Richmond, VA 23230
(804) 497-4676
✔ PECOS✔ Accepts Medicare0.8 mi
Elena Morgan, MD
Family Practice
NPI 1649653197
2913 WAKE FOREST RD
Raleigh, NC 27609
(404) 960-9857
✔ PECOS✔ Accepts Medicare137 mi
Erica Alford, LCSW
Clinical Social Worker
NPI 1093238768
3205 RANDALL PKWY STE 105
Wilmington, NC 28403
(910) 742-9243
✔ PECOS✔ Accepts Medicare233 mi
Linda Cappiello, NURSE PRACTITIONER
Nurse Practitioner
NPI 1174633457
3205 RANDALL PKWY
Wilmington, NC 28403
(910) 742-9243
✔ PECOS✔ Accepts Medicare233 mi
Raul Rodriguez, MD
Psychiatry
NPI 1841554912
428 BILTMORE AVE
Asheville, NC 28801
(828) 213-9906
✔ PECOS313 mi
Isaac Mcfadden, M.D.
Psychiatry
NPI 1316165079
360 E EH CRUMP BLVD
Memphis, TN 38126
(901) 261-2000
✔ PECOS✔ Accepts Medicare719 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifesource Of North Carolina's NPI number?

The NPI number for Lifesource Of North Carolina is 1114419124. It was assigned to this organization in the NPPES registry on June 5, 2018.

Where is Lifesource Of North Carolina located?

Lifesource Of North Carolina is located at 1901 Libbie Ave, Richmond, VA 23226. The listed phone number is (910) 742-9243.

What is Lifesource Of North Carolina's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Lifesource Of North Carolina enrolled in Medicare?

Yes. Lifesource Of North Carolina is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifesource Of North Carolina?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians reassign their Medicare billing to Lifesource Of North Carolina, in Clinical Social Worker, Family Practice, Nurse Practitioner and Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lifesource Of North Carolina was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.