ULTIMATE SACRIFICE NPI 1568050573

NPI Information

  • NPI: 1568050573
  • Provider Name: ULTIMATE SACRIFICE
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Address: 2290 PREMIER PARK LN
    WINSTON SALEM, NC
    ZIP 27105
  • Phone: (336) 254-5796

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NPI Details

ULTIMATE SACRIFICE is a mental health counselor in Winston Salem, NC. ULTIMATE SACRIFICE NPI is 1568050573. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2290 PREMIER PARK LN
WINSTON SALEM, NC
ZIP 27105-306
Phone: (336) 254-5796

The provider's authorized official is Jasmine Tiara Hoyle .
The authorized official title is Ceo and has the following contact phone number (336) 254-5796.

The enumeration date for this NPI number is 1/5/2021 and was last updated on 8/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalNo
2261QP2300XClinic/CenterPrimary CareNo
3342000000XTransportation Network CompanyNo
4364SF0001XClinical Nurse SpecialistFamily HealthNo
5101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
199999MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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