LIFESOURCE OF NORTH CAROLINA (NPI# 1497378848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497378848 |
| Entity Type | Organization |
| Organization Name | LIFESOURCE OF NORTH CAROLINA |
| Practice Address |
8315 Zimpel St New Orleans LA 70118-1169 |
| Mailing Address |
Po Box 538622 Atlanta GA 30353-8622 |
| Practice Telephone | 9107429243 |
| Practice Fax Number | 8887461787 |
| Mailing Telephone | 9105351211 |
| Mailing Fax Number | 9197467603 |
| Enumeration Date | 2020-05-20 |
| Last Update Date | 2020-05-20 |
| Authorized Official Name | PEGGY L 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 | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364S00000X | Clinical Nurse Specialist | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1538728183 | Lifesource of North Carolina | Psychologist | 200 Nursing Home Ln, Pikeville, KY 41501-6896 | 2019-06-07 |
| 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 |
8315 ZIMPEL ST |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70118-1169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791831 | The Administrators of The Tulane Educational Fund | Clinic/Center | 200 Broadway Avenue, Suite 108, New Orleans, LA 70118 | 2020-08-19 |
| 1730674557 | Louisiana Department of Health, Department of Health and Hospitals | Skilled Nursing Facility | 612 Henry Clay Ave., New Orleans, LA 70118 | 2018-06-25 |
| 1588153167 | Kimberly Felicia Fields | Behavior Technician | 733 Dante St., New Orleans, LA 70118 | 2018-05-09 |
| 1275033029 | Antonia Jennice Hollins | Behavior Technician | 733 Dante, New Orleans, LA 70118 | 2018-02-19 |
| 1922521467 | Amy Mcdonald | Specialist/Technologist | 2950 Ben Weiner Dr., Tulane Univ., Athletic Training Rm, 1st Floor, New Orleans, LA 70118 | 2017-07-17 |
| 1760910848 | Tyler Tunnell | Specialist/Technologist | James Wilson Center, 333 Ben Weiner Drive, New Orleans, LA 70118 | 2017-06-01 |
| 1538692801 | Shneitha Beasley | Counselor | 2619 Leonidas St, New Orleans, LA 70118 | 2017-04-04 |
| 1467826966 | Ethan Alan Solger | Specialist/Technologist | 333 James W Wilson Jr Center, New Orleans, LA 70118 | 2015-11-20 |
| 1225402878 | Heather Ravner | Student in an Organized Health Care Education/Training Program | Ben Weiner Drive, James W. Wilson Jr. Center, New Orleans, LA 70118 | 2015-11-19 |
| 1558735142 | Albert Charles Lindon IIi | Specialist/Technologist | 333 Ben Weiner Dr, New Orleans, LA 70118 | 2015-11-19 |
| Find all providers in zip 70118 | ||||
| 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 |
|---|---|---|---|---|
| 1881219251 | Jill E Murray | Social Worker | 824 N Miro St, New Orleans, LA 70119-3503 | 2020-06-11 |
| 1801411350 | Lauren Miller Apple | Social Worker | 1315 Broadway St, New Orleans, LA 70118-5212 | 2020-06-10 |
| 1083249767 | Laura Hasenstein | Social Worker | 3028 Dryades St, New Orleans, LA 70115-5118 | 2020-03-03 |
| 1801433040 | Jonathan Nierman | Social Worker | 1600 Crete St, New Orleans, LA 70119-3021 | 2019-12-06 |
| 1538724471 | Sean Porche Johnson | Social Worker | 4855 Patterson Dr, New Orleans, LA 70131-1925 | 2019-05-06 |
| 1861953184 | Anamaria Villamarin-lupin | Social Worker | 3900 General Taylor St Ste 226, New Orleans, LA 70125-2915 | 2019-03-28 |
| 1144789645 | Reginald A Parquet | Social Worker | 3510 General Meyer Avenue, New Orleans, LA 70114 | 2019-03-14 |
| 1427512227 | Kathryn Davis Wampold | Social Worker | 131 S Robertson St Fl 14, New Orleans, LA 70112-2807 | 2019-01-25 |
| 1013480946 | Melinda B Flynn | Social Worker | 2521 Jena St, 2nd Floor, New Orleans, LA 70115-6322 | 2019-01-03 |
| 1245700160 | Tracey Spinato | Social Worker | 2521 Jena St, New Orleans, LA 70115-6322 | 2018-12-04 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70118 |
Please comment or provide details below to improve the information on LIFESOURCE OF NORTH CAROLINA.
| 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.