Lifesource of North Carolina
NPI 1114419124 · Clinical Social Worker · Richmond, VA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lifesource of North Carolina is a Clinical Social Worker organization in Richmond, VA (NPI 1114419124).
Provider details
- NPI number
- 1114419124
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Peggy Baddour, President/Owner(910) 777-9165
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Psychologist103TC0700X
Behavioral Health & Social Service Providers
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 10307 W Broad St.#309Glen Allen, VA 23060-6716Phone: (910) 742-9243
Registry dates
- Enumerated
- 2018-06-05
- Last updated
- 2021-03-25
- Certified
- 2021-03-25
Frequently asked questions
- What is Lifesource of North Carolina's NPI number?
- Lifesource of North Carolina's National Provider Identifier (NPI) is 1114419124, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lifesource of North Carolina?
- Lifesource of North Carolina is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Lifesource of North Carolina located?
- Lifesource of North Carolina's practice location on file with NPPES is 1901 Libbie Ave, Richmond, VA 23226-1808.
- What is Lifesource of North Carolina's phone number?
- The practice phone number listed in the NPPES registry for Lifesource of North Carolina is (910) 742-9243.
- Does Lifesource of North Carolina accept Medicare?
- Lifesource of North Carolina is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Lifesource of North Carolina?
- The authorized official listed on Lifesource of North Carolina's NPPES record is Peggy Baddour, President/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lifesource of North Carolina's NPI active?
- Yes — Lifesource of North Carolina's NPI (1114419124) is active in the NPPES registry as of the last update on 2021-03-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.