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PEMBROKE CENTER FOR WELLNESS INC NPI 1467726448


NPI Profile

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
Get Directions

Phone: (910) 775-9201

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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalC006439NORTH CAROLINANo
2106H00000XMarriage & Family TherapistLMFT-1304NORTH CAROLINANo
3363LP0808XNurse PractitionerPsychiatric/Mental Health5000705NORTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15917311MEDICAIDNORTH 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: 4/11/2021

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