LIFESOURCE OF NORTH CAROLINA
NPI 1295311595
Psychiatry & Neurology - Psychiatry in South Bend, IN

Q: What is Lifesource Of North Carolina's NPI number?

The NPI number for Lifesource Of North Carolina is 1295311595. It was assigned to this organization in the NPPES registry on March 18, 2021.

Q: What is Lifesource Of North Carolina's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since March 18, 2021

4600 W WASHINGTON ST, SOUTH BEND, IN 46619(910) 742-9243(888) 746-1787 Get Directions Write a Review

NPPES record last updated: March 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Lifesource Of North Carolina NPPES

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

LIFESOURCE OF NORTH CAROLINA (NPI 1295311595) is a healthcare organization registered as a psychiatry in South Bend, Indiana and active in the NPI registry since March 2021. The organization lists Peggy Baddour, President, as its authorized official.

NPPES Registry Identity

NPI1295311595

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NameLIFESOURCE OF NORTH CAROLINA

Location Address4600 W WASHINGTON STSouth Bend, IN 46619-2320

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) 777-9165

Enumeration DateMarch 18, 2021

NPPES CertifiedMarch 18, 2021

✔ NPI 1295311595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

4600 W WASHINGTON ST, South Bend, IN 46619

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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 4

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

ADITI SURYAKANT DATTA PT

Physical Therapist

4600 W WASHINGTON ST
SOUTH BEND, IN 46619

St. Joseph County (574) 282-1294

TRINITY CONTINUING CARE SERVICES

Durable Medical Equipment & Medical Supplies (Parenteral & Enteral Nutrition)

4600 W WASHINGTON ST
SOUTH BEND, IN 46619

St. Joseph County (574) 282-1294

VICKY JO GROSS NP

Nurse Practitioner (Adult Health)

4600 W WASHINGTON ST
SOUTH BEND, IN 46619

St. Joseph County (574) 282-1294

HENRY COUNTY MEMORIAL HOSPITAL

Skilled Nursing Facility

4600 W WASHINGTON ST
SOUTH BEND, IN 46619

St. Joseph County (574) 282-1294

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 1295311595. It was assigned to this organization in the NPPES registry on March 18, 2021.

Where is Lifesource Of North Carolina located?

Lifesource Of North Carolina is located at 4600 W Washington St, South Bend, IN 46619. The listed phone number is (910) 742-9243.

What is Lifesource Of North Carolina's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

When was this NPI record last updated?

The NPPES record for Lifesource Of North Carolina was last updated on March 18, 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.