Lifesource of North Carolina

NPI #1972861789 in Clinton, South Carolina

Provider Information

NPI Number: 1972861789
Entity Type: Organization
Organization Name: Lifesource of North Carolina
Primary Specialty: General Practice
Enumeration Date: Apr 30, 2012
Last Updated: May 17, 2022

Practice Location

Address: 939 SPRINGDALE DR
City: Clinton
State: South Carolina
ZIP Code: 29325-7266
Phone: (910) 742-9243

Authorized Official

Name: PEGGY L BADDOUR
Title: PRESIDENT/OWNER
Phone: (910) 777-9165

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X
Social Worker - Clinical — Clinical	1041C0700X
Family Medicine	207Q00000X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
General Practice	208D00000X	Primary

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