LIFESOURCE OF NORTH CAROLINA (NPI# 1538728183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538728183 |
| Entity Type | Organization |
| Organization Name | LIFESOURCE OF NORTH CAROLINA |
| Practice Address |
200 Nursing Home Ln Pikeville KY 41501-6896 |
| Mailing Address |
Po Box 538622 Atlanta GA 30353-8622 |
| Practice Telephone | 9107429243 |
| Practice Fax Number | 8887461787 |
| Mailing Telephone | 9105351211 |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-04-14 |
| Authorized Official Name | PEGGY BADDOUR (PRESIDENT) |
| Authorized Official Telephone | 9105351211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497378848 | Lifesource of North Carolina | Psychologist | 8315 Zimpel St, New Orleans, LA 70118-1169 | 2020-05-20 |
| 1649877762 | Lifesource of North Carolina | Psychologist | 501 2nd St, Menominee, MI 49858-3203 | 2020-10-01 |
| 1972131308 | Lifesource of North Carolina | Psychologist | 140 Park Ave, Bloomfield, CT 06002-3207 | 2020-03-31 |
| 1619515277 | Lifesource of North Carolina | Psychologist | 204 W Main St, New London, OH 44851-1070 | 2019-12-13 |
| 1801431127 | Lifesource of North Carolina | Psychologist | 725 2nd Ave S, Hopkins, MN 55343-7782 | 2019-11-11 |
| 1174168496 | Lifesource of North Carolina | Psychologist | 600 Main St S, Minot, ND 58701-4499 | 2019-11-11 |
| 1801431440 | Lifesource of North Carolina | Psychologist | 1728 W 8th St, Cedar Falls, IA 50613-2002 | 2019-11-07 |
| 1093350647 | Lifesource of North Carolina | Psychologist | 2900 W E St, North Platte, NE 69101-1803 | 2019-11-07 |
| 1871135723 | Lifesource of North Carolina | Psychologist | 3540 S 43rd St, Milwaukee, WI 53220-1502 | 2019-10-11 |
| 1730648288 | Lifesource of North Carolina | Social Worker | 5530 Northrop Rd, Milton, FL 32570-8701 | 2019-03-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | LifeSource of North Carolina Inc. | 5617 Maxwell Place, Wilmington, North Carolina 28408 |
| Alabama Business Registrations | LifeSource of North Carolina, Inc. | 5617 Maxwell Place, Wilmington, NC 28409 |
| Street Address |
200 NURSING HOME LN |
| City | PIKEVILLE |
| State | KY |
| Zip Code | 41501-6896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518905215 | Parkview Healthcare LLC | Skilled Nursing Facility | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2006-06-03 |
| 1053932681 | Parkview Ky Opco LLC | Skilled Nursing Facility | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2020-05-05 |
| 1699334342 | Lesley Ann Bishop | Speech-Language Pathologist | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2019-06-06 |
| 1831616549 | Courtney Danielle Mullins | Physical Therapy Assistant | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2017-08-23 |
| 1437530698 | Stacey Nicole Vawter | Speech-Language Pathologist | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2015-06-13 |
| 1336537141 | Leslie Seals | Physical Therapy Assistant | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2014-12-31 |
| 1225426141 | Bridgette Nicole Slone | Occupational Therapy Assistant | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2014-12-30 |
| 1235495235 | Carla Fields | Physical Therapist | 200 Nursing Home Ln, Therapy Dept, Pikeville, KY 41501-6896 | 2012-04-04 |
| 1669743613 | Robin Michelle Hopkins | Skilled Nursing Facility | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2012-01-23 |
| 1306117353 | Valary Sue Sykes | Nursing Facility/Intermediate Care Facility | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2012-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720634 | Lauren Ann Thacker | Nurse Practitioner | 648 Stonehenge Drive, Pikeville, KY 41501 | 2020-11-03 |
| 1659933406 | Wesley Tyler Rowe | Pharmacist | 553 Hambley Boulevard, Suite 6, Pikeville, KY 41501 | 2019-07-02 |
| 1275096489 | Eric Taejun Kim | Student in an Organized Health Care Education/Training Program | 184 South Mayo Trail, Pikeville, KY 41501 | 2019-04-13 |
| 1245755206 | Paula Renee Belcher | Nurse Practitioner | 5724 E Shelbiana Road, Pikeville, KY 41501 | 2017-08-10 |
| 1174044390 | Jessie C Deffendall | Dentist | 220 Cassidy Blvd, Pikeville, KY 41501 | 2017-06-28 |
| 1942667456 | Crossroads Addiction Recovery Effort, LLC | Family Medicine | 484 Tollage Crk, Pikeville, KY 41501 | 2016-01-28 |
| 1265836183 | Rebecca Leann Roberts | Pharmacist | 259 Bear Rd, Pikeville, KY 41501 | 2014-10-21 |
| 1306253190 | Ginger Webb Aprn | Clinic/Center | 153 Weddington Branch Rd., Pikeville, KY 41501 | 2014-07-14 |
| 1710323894 | Bhg Xxv, LLC | Case Management | 368 South Mayo Trail, Pikeville, KY 41501 | 2013-05-16 |
| 1740624220 | Sunrise Children's Services, Inc. | Foster Care Agency | 123 Weddington Branch Road, Pikeville, KY 41501 | 2013-04-26 |
| Find all providers in zip 41501 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215457544 | Anchored Hope Counseling and Consulting | Social Worker | 6883 Millard Hwy Ste 2, Pikeville, KY 41501-7945 | 2017-06-27 |
| 1093108052 | Shirley Rogers | Social Worker | 563 Mooneyham Rd, Pikeville, TN 37367-6034 | 2015-03-13 |
| 1003243874 | Sheena Scott | Social Worker | 14766 State Highway 194 W, Pikeville, KY 41501-5416 | 2013-10-10 |
| 1144562323 | Carter and May, Qmhp | Social Worker | 178 2nd St Ste B, Pikeville, KY 41501-4069 | 2013-03-26 |
| 1609113307 | Susanne D Falk | Social Worker | 553 Sudbrook Lane, Pikeville, MD 21208 | 2013-01-15 |
| 1487768990 | Martha E. Copley Coleman | Social Worker | 118 River Dr, Pikeville, KY 41501-1597 | 2006-08-19 |
| 1467566984 | Martha K. Hettinger | Social Worker | 118 River Dr, Pikeville, KY 41501-1597 | 2006-08-19 |
| 1356455950 | Morris D. Smith Jr. | Social Worker | 118 River Dr, Pikeville, KY 41501-1597 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929362 | Linda Flynn Lengal | Social Worker | 3600 Winthrop Dr Apt 9211, Lexington, KY 40514-1871 | 2020-10-12 |
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1609481464 | Gml Pain Md Psc | Social Worker | 110 Chase Way, Elizabethtown, KY 42701-7827 | 2020-09-09 |
| 1952915688 | Crossroads Therapy & Counseling LLC | Social Worker | 9910 Ky Route 581, River, KY 41254 | 2020-09-01 |
| 1972115699 | Christa Kay Butcher | Social Worker | 9910 Rt 581, River, KY 41254 | 2020-08-24 |
| 1568074136 | Jalena Louise Robertson Adams | Social Worker | 2218 Lyons Station Rd, New Haven, KY 40051-8723 | 2020-08-17 |
| 1649881368 | Melissa Lou Salisbury | Social Worker | 657 Warco Rd, Langley, KY 41645-6572 | 2020-08-14 |
| 1689283202 | Jenny K Delap | Social Worker | 202 E Vista St, Lexington, KY 40503-1327 | 2020-07-29 |
| 1295344489 | Haley Faye Price | Social Worker | 114 Brandywine Dr, Georgetown, KY 40324-1441 | 2020-07-24 |
| 1700494598 | Bluegrass Behavioral Health Services LLC | Social Worker | 501 Marsailles Rd Ste 3, Versailles, KY 40383-1911 | 2020-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.