Healthcare Provider Details

I. General information

NPI: 1528794054
Provider Name (Legal Business Name): HEALING VIBES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102B S 12TH ST
ERWIN NC
28339-2118
US

IV. Provider business mailing address

102B S 12TH ST
ERWIN NC
28339-2118
US

V. Phone/Fax

Practice location:
  • Phone: 910-591-2120
  • Fax:
Mailing address:
  • Phone: 910-591-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTA GRAVES REID
Title or Position: THERAPIST
Credential: MSW, LCSWA
Phone: 910-818-0142