LIFESOURCE OF NORTH CAROLINA
NPI 1619515277
Social Worker - Clinical in Holland, OH

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

The NPI number for Lifesource Of North Carolina is 1619515277. It was assigned to this organization in the NPPES registry on December 13, 2019.

Q: 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.

Active since December 13, 2019

1525 EBER RD, HOLLAND, OH 43528(910) 742-9243(888) 746-1787 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 10, 2024, Nov 24, 2021, Mar 25, 2021 and 1 more (4 updates tracked since 2019).

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About Lifesource Of North Carolina NPPES

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

LIFESOURCE OF NORTH CAROLINA (NPI 1619515277) is a healthcare organization registered as a clinical in Holland, Ohio and active in the NPI registry since December 2019. The organization lists Peggy Baddour, President, as its authorized official.

NPPES Registry Identity

NPI1619515277

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameLIFESOURCE OF NORTH CAROLINA

Location Address1525 EBER RDHolland, OH 43528-9616

Mailing AddressPo Box 538622Atlanta, GA 30353-8622 · (910) 535-1211 · Fax (919) 746-7603

Phone(910) 742-9243

Fax(888) 746-1787

Organization SubpartNo

Authorized OfficialPeggy BaddourPresident · (910) 777-9165

Enumeration DateDecember 13, 2019

Last NPPES UpdateApril 10, 20244 updates tracked since enumeration

NPPES CertifiedApril 10, 2024

✔ NPI 1619515277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ 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 ListedSocial WorkerTaxonomy 104100000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

1525 EBER RD, Holland, OH 43528

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 10

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

MS. COLLEEN CATHERINE TYE L.P.T.

Physical Therapist