Active NPI
Sacred Path Psychiatry
- Psychiatric/Mental Health Nurse Practitioner
- Charlotte, NC
National Provider Identifier
1386564300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- SACRED PATH PSYCHIATRY
- Practice address
- 301 S McDowell St Ste 125-2060
Charlotte, NC 28204-2623 - Phone
- (803) 417-6325
- NPI assigned
- Jul 20, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kendra Blackwell
- Title
- Ceo
- Phone
- (803) 417-6325
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
301 S McDowell St Ste 125-2060
Charlotte, NC 28204-2623
Mailing address
1723 Valkrie PL
York, SC 29745-6625
Phone (803) 417-6325
National Provider Directory
National Provider DirectoryLocations
301 S McDowell St
Ste 1252060
Charlotte, NC 28204
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784505600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784505600000",
"number": "1386564300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1723 VALKRIE PL",
"city": "YORK",
"state": "SC",
"postal_code": "297456625",
"telephone_number": "803-417-6325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S MCDOWELL ST STE 125-2060",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042623",
"telephone_number": "803-417-6325"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SACRED PATH PSYCHIATRY",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-20",
"last_updated": "2026-07-20",
"certification_date": "2026-07-20",
"status": "A",
"authorized_official_last_name": "BLACKWELL",
"authorized_official_first_name": "KENDRA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "803-417-6325"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.