DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SACRED PATH PSYCHIATRY

MEDICARE: SACRED PATH PSYCHIATRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1407646961
Entity Type Code : Organization
Provider Name (Legal Business Name) : SACRED PATH PSYCHIATRY
Provider Business Mailing Address
First Line : 1723 VALKRIE PL
Second Line :
City : YORK
State : SC
Zip : 29745-6625
Country : US
Telephone Number : 803-417-6325
Fax Number :
Provider Business Practice Location Address
First Line : 301 S MCDOWELL ST STE 125
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-0031
Country : US
Telephone Number : 803-417-6325
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KENDRA BLACKWELL
Credential : PMHNP
Telephone Number : 803-417-6325
Provider Enumeration Date : 05/08/2025
Last Update Date : 05/08/2025

Similar Medicare Providers

1174209860 — OMEGA GROUP LLC
Practice Location Address:
301 S MCDOWELL ST STE 125
CHARLOTTE, NC
28204-0031
Practice Phone: 443-822-4357
Practice Fax:
1366123291 — VIRGINIA HUMPHRIES
Practice Location Address:
301 S MCDOWELL ST STE 125
CHARLOTTE, NC
28204-0031
Practice Phone: 256-520-4397
Practice Fax:
1205695228 — CAROLINAS CONNECTIONS HOME HEALTH
Practice Location Address:
301 S MCDOWELL ST STE 125
CHARLOTTE, NC
28204-0031
Practice Phone: 786-893-7030
Practice Fax:
1386436988 — PEACE LILY COUNSELING SERVICES PLLC
Practice Location Address:
301 S MCDOWELL ST STE 125
CHARLOTTE, NC
28204-0031
Practice Phone: 484-742-3312
Practice Fax:
1164386520 — TAMARA THOMAS
Practice Location Address:
301 S MCDOWELL ST STE 125
CHARLOTTE, NC
28204-0031
Practice Phone: 704-312-0356
Practice Fax:
1336515873 — JAN LARAE EVERHART NEWMAN PH.D.
Practice Location Address:
3318 PARTING BROOK CT
CHARLOTTE, NC
28210-8159
Practice Phone: 704-444-0087
Practice Fax:

Directions to “SACRED PATH PSYCHIATRY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.