Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifesource of North Carolina

Organization Clinical Psychologist · NPI 1114419124

Lifesource of North Carolina is a Clinical Psychologist in Richmond, Virginia. Works from 2 locations. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
5

Practice location Address checks out

1901 Libbie Ave
Richmond, VA 23226-1808
Phone: (910) 742-9243
Fax: (888) 746-1787
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 10307 W Broad St., Glen Allen, VA 23060-6716 — (910) 742-9243

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Clinical Psychologist Taxonomy 103TC0700X
Psychiatry Physician Taxonomy 2084P0800X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1114419124
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peggy Baddour — President/Owner · (910) 777-9165
NPI enumeratedJune 5, 2018
Last updated in NPPESMarch 25, 2021
Certification dateMarch 25, 2021
Mailing addressPo Box 538622, Atlanta, GA 30353-8622

Other providers in Richmond