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

Lifesource of North Carolina

Organization Psychiatry Physician · NPI 1710620117

Lifesource of North Carolina is a Psychiatry Physician in Holland, Ohio. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
4

Practice location Address checks out

1525 Eber Rd
Holland, OH 43528-9616
Phone: (910) 742-9243
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Psychiatry Physician Taxonomy 2084P0800X
Physician Assistant Taxonomy 363A00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1710620117
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amanda Seymour — Credentialing Specialist · (910) 794-4521
NPI enumeratedApril 14, 2022
Last updated in NPPESApril 10, 2024
Certification dateApril 10, 2024
Mailing addressPo Box 538622, Atlanta, GA 30353-8622

Other providers in Holland