PEMBROKE CENTER FOR WELLNESS INC NPI 1467726448

NPI Information

NPI: 1467726448
Provider Name: PEMBROKE CENTER FOR WELLNESS, INC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
773 OLD MAIN RD
PEMBROKE, NC
ZIP 28372
Phone: (910) 775-9201
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PEMBROKE CENTER FOR WELLNESS, INC is a psychiatric/mental health nurse practitioner in Pembroke, NC. PEMBROKE CENTER FOR WELLNESS, INC NPI is 1467726448. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

773 OLD MAIN RD
PEMBROKE, NC
ZIP 28372-753
Phone: (910) 775-9201
Fax: (910) 521-8540

The provider's authorized official is Ella Olehonna Lynch .
The authorized official title is President, Ceo and has the following contact phone number (910) 775-9201.

The enumeration date for this NPI number is 3/8/2012 and was last updated on 1/18/2013.

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
1	1041C0700X	Social Worker	Clinical	C006439	NORTH CAROLINA	No
2	106H00000X	Marriage & Family Therapist		LMFT-1304	NORTH CAROLINA	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	5000705	NORTH CAROLINA	Yes

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
1	5917311	MEDICAID	NORTH 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: 11/14/2023

NPI Synchronization or Removal

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