# PEMBROKE CENTER FOR WELLNESS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467726448
- **Authorized official:** MRS. ELLA OLEHONNA LYNCH FNP-C, PMHNP-BC (PRESIDENT, CEO)
- **Authorized official phone:** (910) 775-9201

## Contact information

- **Practice address:** 773 OLD MAIN RD, PEMBROKE, NC 28372-8753
- **Practice address phone:** (910) 775-9201
- **Practice address fax:** (910) 521-8540
- **Mailing address:** 773 OLD MAIN RD, PEMBROKE, NC 28372-8753
- **Mailing address phone:** (910) 775-9201
- **Mailing address fax:** (910) 521-8540

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | C006439 | NC | — |
| 106H00000X | Marriage & Family Therapist | LMFT-1304 | NC | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 5000705 | NC | Yes |

## Other

- **Enumeration date:** 03/08/2012
- **Last updated:** 01/18/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5917311 | — | NC |