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

Lifesource of North Carolina

Organization Clinical Psychologist · NPI 1811286156

Lifesource of North Carolina is a Clinical Psychologist in Wilmington, North Carolina. Works from 2 locations. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
7
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Practice location Address checks out

3205 Randall Pkwy Ste 105
Wilmington, NC 28403
Phone: (910) 742-9243
Fax: (888) 746-1787
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4002 Executive Park Blvd Ste 300, Southport, NC 28461-9080 — (910) 742-9243

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Clinical Psychologist Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Family Medicine Physician Taxonomy 207Q00000X
Psychiatry Physician Taxonomy 2084P0800X
Physician Assistant Taxonomy 363A00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1811286156
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peggy Baddour — President/Owner · (910) 777-9165
NPI enumeratedApril 6, 2011
Last updated in NPPESDecember 29, 2021
Certification dateDecember 29, 2021
Mailing addressPo Box 538622, Lifesource Of North Carolina, Atlanta, GA 30353-8622

Other providers in Wilmington