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Organization
SACRED PATH PSYCHIATRY
Active
Organization
SACRED PATH PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA BLACKWELL (CEO)
(803) 417-6325
Entity
Organization
Contact information
Practice address
301 S MCDOWELL ST STE 125-2060, CHARLOTTE, NC 28204-2623
(803) 417-6325
Mailing address
1723 VALKRIE PL, YORK, SC 29745-6625
(803) 417-6325
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/20/2026
Last updated
07/20/2026
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