Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Sacred Earth Healing Village PLLC

Organization Mental Health Counselor · NPI 1578435103

Sacred Earth Healing Village PLLC provides Mental Health Counselor services in Greensboro, North Carolina. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1451 S Elm Eugene St Ste 2308
Greensboro, NC 27406-2200
Phone: (336) 303-8421
Fax: (336) 464-2137
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1578435103
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Krystin Fullwood — Owner · (336) 280-9976
NPI enumeratedSeptember 23, 2025
Last updated in NPPESSeptember 25, 2025
Certification dateSeptember 25, 2025
Mailing address1451 S Elm Eugene St Ste 2308, Greensboro, NC 27406-2200

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