Lifesource of North Carolina
NPI 1730648288 · Psychologist · Milton, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1730648288
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Peggy Baddour, President(910) 777-9165
Specialties & taxonomies
Behavioral Health & Social Service Providers
Physician Assistants & Advanced Practice Nursing Providers
- Clinical Social Worker1041C0700X
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
7 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
- 2019-03-14
- Last updated
- 2021-03-25
- Certified
- 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.