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SACRED EARTH HEALING VILLAGE PLLC
NPI 1578435103
Counselor - Mental Health in Greensboro, NC

Active since September 23, 2025
1451 S ELM EUGENE ST STE 2308, GREENSBORO, NC 27406(336) 303-8421(336) 464-2137 Get Directions Write a Review

NPPES record last updated: September 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sacred Earth Healing Village Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SACRED EARTH HEALING VILLAGE PLLC (NPI 1578435103) is a healthcare organization registered as a mental health in Greensboro, North Carolina and active in the NPI registry since September 2025. The organization lists Krystin Jherel Fullwood, Owner, as its authorized official.

NPPES Registry Identity

NPI1578435103
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameSACRED EARTH HEALING VILLAGE PLLC
Location Address1451 S ELM EUGENE ST STE 2308Greensboro, NC 27406-2200
Mailing Address1451 S Elm Eugene St Ste 2308Greensboro, NC 27406-2200 · (336) 303-8421 · Fax (336) 464-2137
Phone(336) 303-8421
Fax(336) 464-2137
Organization SubpartNo
Authorized OfficialKrystin Jherel FullwoodOwner · (336) 280-9976
Enumeration DateSeptember 23, 2025
Last NPPES UpdateSeptember 25, 2025
NPPES CertifiedSeptember 25, 2025
✔ NPI 1578435103 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1451 S ELM EUGENE ST STE 2308, Greensboro, NC 27406
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sacred Earth Healing Village PLLC's NPI number?

The NPI number for Sacred Earth Healing Village PLLC is 1578435103. It was assigned to this organization in the NPPES registry on September 23, 2025.

Where is Sacred Earth Healing Village PLLC located?

Sacred Earth Healing Village PLLC is located at 1451 S Elm Eugene St Ste 2308, Greensboro, NC 27406. The listed phone number is (336) 303-8421.

What is Sacred Earth Healing Village PLLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Sacred Earth Healing Village PLLC was last updated on September 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.