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

Lifesource of North Carolina

Organization Psychologist · NPI 1962940817

Lifesource of North Carolina is a Psychologist in Rome, Georgia. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
7

Practice location Address checks out

1345 Redmond Cir NW
Rome, GA 30165-1307
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

General Practice Physician (primary) Taxonomy 208D00000X
Psychologist Taxonomy 103T00000X
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 number1962940817
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLifesource of North Carolina
Authorized official Peggy Baddour — President · (910) 777-9165
Other names Lifesource Of Georgia; Lifesource Of Georgia
NPI enumeratedFebruary 10, 2017
Last updated in NPPESMarch 26, 2021
Certification dateMarch 26, 2021
Mailing addressPo Box 538622, Atlanta, GA 30353-8622

Other providers in Rome