Lifesource Of North Carolina - Mental Health Clinic in Cheyenne, WY

Lifesource Of North Carolina is a mental health clinic (General Practice) in Cheyenne, Wyoming. The current practice location for Lifesource Of North Carolina is 1208 E Pershing Blvd, Cheyenne, Wyoming. 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) 742-9243.

Lifesource Of North Carolina is licensed to practice in * (Not Available) (license number ) and its NPI number is 1386144418. This medical practice does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at (910) 742-9243.

Contact Information

Lifesource Of North Carolina
1208 E Pershing Blvd
Cheyenne
WY 82001-3230
(910) 742-9243
(888) 746-1787

Mental Health Clinic Profile

Full NameLifesource Of North Carolina
SpecialityGeneral Practice
Location1208 E Pershing Blvd, Cheyenne, Wyoming
Authorized Official Name and PositionPeggy Baddour (PRESIDENT/OWNER)
Authorized Official Contact9107779165
Accepts Medicare InsuranceThis clinic does not participate in Medicare Program.

Mailing Address and Practice Location

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

Ph: (910) 742-9243
Lifesource Of North Carolina
1208 E Pershing Blvd
Cheyenne
WY 82001-3230

Ph: (910) 742-9243

NPI Details:

NPI Number1386144418
Provider Enumeration Date02/15/2018
Last Update Date03/25/2021
Certification Date03/25/2021

Medical Identifiers

Medical identifiers for Lifesource Of North Carolina such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1386144418NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical (* (Not Available))Secondary
1041C0700XSocial Worker - Clinical (* (Not Available))Secondary
207Q00000XFamily Medicine (* (Not Available))Secondary
2084P0800XPsychiatry & Neurology - Psychiatry (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Primary
363A00000XPhysician Assistant (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

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