Lifesource Therapy LLC
NPI 1003660036ActiveOrganization· Counselor, Mental Health· Bend, OR
Counselor, Mental Health in Bend, Oregon, registered in NPPES in April 2024. The authorized official on file is Gina R. Lawrence, LPC, Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003660036 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 16, 2024 |
| Last updated in NPPES | Aug 18, 2025 |
| Certified by provider | Aug 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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