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 1649877762

Lifesource of North Carolina is a Clinical Psychologist in Menominee, Michigan. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
5

Practice location Address checks out

501 2nd St
Menominee, MI 49858-3203
Phone: (910) 742-9243
Fax: (888) 746-1787
Show map & directions

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

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 number1649877762
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peggy Baddour — President · (910) 338-2882
NPI enumeratedOctober 1, 2020
Last updated in NPPESMarch 25, 2021
Certification dateMarch 25, 2021
Mailing addressPo Box 538622, Atlanta, GA 30353-8622

Other providers in Menominee