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

Lifesource Therapy LLC

Organization Mental Health Counselor · NPI 1003660036

Lifesource Therapy LLC is a Mental Health Counselor in Bend, Oregon. Works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

24455 Dodds Rd
Bend, OR 97701-9665
Phone: (541) 777-7230
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 103 Lucky Dr, Silsbee, TX 77656-3107 — (541) 777-7230

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1003660036
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gina Lawrence — Provider · (541) 777-7230
Other names Gina Lawrence
NPI enumeratedApril 16, 2024
Last updated in NPPESAugust 18, 2025
Certification dateAugust 18, 2025
Mailing address1900 Ne 3rd St Ste 106, Bend, OR 97701-3889

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