Graceland Student Services LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

GRACELAND STUDENT SERVICES LLC

Practice address

610 Fairview Ave.
Wilson, NC 27893

Phone

(919) 593-7324

NPI assigned

Sep 30, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Krystle M. JohnsonNPI 1134411648

Title

Co-Owner

Phone

(919) 593-7324

Specialties & licenses 5

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krystle Johnson, ITFS

  • Developmental Therapist
  • Las Vegas, NV
  • NPI 1134411648
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1245847524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 31",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27894",
            "telephone_number": "919-593-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 FAIRVIEW AVE.",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "27893",
            "telephone_number": "919-593-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACELAND STUDENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "919-593-7324",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Lorena Gottula, LCMHC
• Katie Leigh Goulet, PHARM.D., MSCR, BS
• Cameron Flores Goyette
• Grace 4 the Youth LLC.
• Sandra Ann Grace, LCAS
• Laura Graham, MS, CCC-SLP
• Sheryl Lashell Green, LMBT
• Gregory E Edwards
• Robert D Gregory, PH.D.
• Keesha Grice, LCMHCA, LCASA

• Early Intervention Provider Agency in Wilson, NC
• Providers in Wilson, NC by specialty
• Early Intervention Provider Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.