Lifesource of North Carolina
NPI 1619515277 · Clinical Social Worker · Holland, OH
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 Holland, OH (NPI 1619515277).
Provider details
- NPI number
- 1619515277
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Peggy Baddour, President(910) 777-9165
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
- Clinical Psychologist103TC0700X
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
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
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Registry dates
- Enumerated
- 2019-12-13
- Last updated
- 2024-04-10
- Certified
- 2024-04-10
Frequently asked questions
- What is Lifesource of North Carolina's NPI number?
- Lifesource of North Carolina's National Provider Identifier (NPI) is 1619515277, 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 1525 Eber Rd, Holland, OH 43528-9616.
- 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. 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 (1619515277) is active in the NPPES registry as of the last update on 2024-04-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.