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LIFESOURCE OF NORTH CAROLINA

Clinical Social Worker

NPI: 1114419124Organization

Specialties, Licenses & Credentials

Psychologist — Clinical

Code: 103TC0700X

Social Worker — Clinical

Code: 1041C0700X

Psychiatry & Neurology — Psychiatry

Code: 2084P0800X

Physician Assistant

Code: 363A00000X

Nurse Practitioner

Code: 363L00000X

Contact & Hours

Via practice · 2 locations total

Address
10307 W Broad St., #309
Glen Allen, VA 23060

Quick Facts

NPI
1114419124
Entity Type
Organization
Medicare
Not confirmed
Specialties
5
Locations
2

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