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LIFESOURCE OF NORTH CAROLINA
NPI 1174168496
Social Worker - Clinical in Minot, ND

Active since November 11, 2019
600 MAIN ST S, MINOT, ND 58701(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: July 26, 2026.

Record update history: Mar 25, 2021, Nov 11, 2019 (2 updates tracked since 2019).

About Lifesource Of North Carolina NPPES

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

LIFESOURCE OF NORTH CAROLINA (NPI 1174168496) is a healthcare organization registered as a clinical in Minot, North Dakota and active in the NPI registry since November 2019. The organization lists Peggy Baddour, President, as its authorized official.

NPPES Registry Identity

NPI1174168496
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameLIFESOURCE OF NORTH CAROLINA
Location Address600 MAIN ST SMinot, ND 58701-4499
Mailing AddressPo Box 538622Atlanta, GA 30353-8622 · (910) 742-9243 · Fax (888) 746-1787
Phone(910) 742-9243
Fax(888) 746-1787
Organization SubpartNo
Authorized OfficialPeggy BaddourPresident · (910) 338-2882
Enumeration DateNovember 11, 2019
Last NPPES UpdateMarch 25, 20212 updates tracked since enumeration
NPPES CertifiedMarch 25, 2021
✔ NPI 1174168496 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
600 MAIN ST S, Minot, ND 58701
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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

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. SIERRA NICOLE GRAGG PTA
Physical Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 837-3816
MELISSA LEE SOBER
Physical Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 852-1255
CANDICE LEE LUGIBIHL COTA
Occupational Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 852-1255
MRS. JANELLE RENEE LEONARD COTA/L
Occupational Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 837-3816
GEORGIA RAE KREIN NP
Nurse Practitioner
600 MAIN ST S, MCHS MINOT / HEARTLAND CARE PARTNERS
MINOT, ND 58701
Ward County (800) 375-5495
MINOT HEALTH AND REHAB LLC
Skilled Nursing Facility
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 852-1255
MRS. BRANDI ELIZABETH DEARING PTA
Physical Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 837-3816
DENISE MARIE AUSTIN COTA
Occupational Therapy Assistant
600 MAIN ST S
MINOT, ND 58701
Ward County (701) 837-3816

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 1174168496. It was assigned to this organization in the NPPES registry on November 11, 2019.

Where is Lifesource Of North Carolina located?

Lifesource Of North Carolina is located at 600 Main St S, Minot, ND 58701. 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.

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 with the weekly NPPES data releases published by CMS.