Lifesource Of North Carolina - Medicare Mental Health Clinic in Holland, OH

Lifesource Of North Carolina is a medicare enrolled mental health clinic (Social Worker - Clinical) in Holland, Ohio. The current practice location for Lifesource Of North Carolina is 1525 Eber Rd, Holland, Ohio. For appointments, you can reach them via phone at (910) 742-9243. The mailing address for Lifesource Of North Carolina is Po Box 538622, Atlanta, Georgia and phone number is (910) 535-1211.

Lifesource Of North Carolina is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1619515277. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (910) 742-9243.

Contact Information

Lifesource Of North Carolina
1525 Eber Rd
Holland
OH 43528-9616
(910) 742-9243
(888) 746-1787

Map and Direction


Mental Health Clinic Profile

Full NameLifesource Of North Carolina
SpecialitySocial Worker
Location1525 Eber Rd, Holland, Ohio
Authorized Official Name and PositionPeggy Baddour (PRESIDENT)
Authorized Official Contact9107779165
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lifesource Of North Carolina
Po Box 538622
Atlanta
GA 30353-8622

Ph: (910) 535-1211
Lifesource Of North Carolina
1525 Eber Rd
Holland
OH 43528-9616

Ph: (910) 742-9243

NPI Details:

NPI Number1619515277
Provider Enumeration Date12/13/2019
Last Update Date04/10/2024
Certification Date04/10/2024

Medicare PECOS Information:

Medicare PECOS PAC ID7416132428
Medicare Enrollment IDO20200212002188

Medical Identifiers

Medical identifiers for Lifesource Of North Carolina such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619515277NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical (* (Not Available))Secondary
104100000XSocial Worker (* (Not Available))Secondary
1041C0700XSocial Worker - Clinical (* (Not Available))Primary
207R00000XInternal Medicine (* (Not Available))Secondary
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Secondary
363A00000XPhysician Assistant (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lifesource Of North Carolina acts as a billing entity for following providers:
Provider NameRyan P Peirson
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1740381409
PECOS PAC ID: 9234235037
Enrollment ID: I20071031000578
Provider NameNeal W Dunsieth
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1245324961
PECOS PAC ID: 2567542004
Enrollment ID: I20080109000435
Provider NameLoraine R Maguire
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1174705420
PECOS PAC ID: 6002999588
Enrollment ID: I20080206000502
Provider NameGretchen Rhea Horner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1962667691
PECOS PAC ID: 3577622521
Enrollment ID: I20100415000351
Provider NameFariba Mazdeh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669786117
PECOS PAC ID: 3072706704
Enrollment ID: I20101026000537
Provider NameGregg Alan Stephens
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1053508309
PECOS PAC ID: 5092023952
Enrollment ID: I20150928000549
Provider NameAngela S Ellison
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1871134999
PECOS PAC ID: 0446684856
Enrollment ID: I20191217003369
Provider NameBryce Yates
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487184446
PECOS PAC ID: 4688931298
Enrollment ID: I20210301001650
Provider NameKelley Fulkerson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1578942140
PECOS PAC ID: 4385070036
Enrollment ID: I20220427002003
Provider NameJessica Fournier
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033857727
PECOS PAC ID: 9830570043
Enrollment ID: I20220720000004
Provider NameLinda Cappiello
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174633457
PECOS PAC ID: 6901815836
Enrollment ID: I20230511002531

Reviews and Comments

Social Worker in Holland, OH

Usaf
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 418 Shrewsbury St, Holland, OH 43528
Phone: 419-509-7513    
Newness Of Life Counseling Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 7445 Airport Hwy Ste E, Holland, OH 43528
Phone: 419-280-5890    Fax: 419-280-5890
Jane Broering Ammons
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 7429 International Dr, #2, Holland, OH 43528
Phone: 419-866-8232    Fax: 419-866-8233
Racing For Recovery
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 6202 Trust Dr, Holland, OH 43528
Phone: 419-824-8462    
Kerry L. Garretson, Ph.d.
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 6912 Spring Valley Dr, Suite 202c, Holland, OH 43528
Phone: 419-866-4644    Fax: 419-861-5040
Bryans Treatment Center
Mental Health Clinic
Medicare: Medicare Enrolled
Practice Location: 6648 South Ave, Holland, OH 43528
Phone: 141-945-08273    
Goodlife Inc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 7429 International Dr, Holland, OH 43528
Phone: 419-866-7700    Fax: 419-866-1695

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.