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Organization

PEMBROKE CENTER FOR WELLNESS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ELLA OLEHONNA LYNCH FNP-C, PMHNP-BC (PRESIDENT, CEO)
(910) 775-9201
Entity
Organization

Contact information

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

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5917311
NC
Enumeration date
03/08/2012
Last updated
01/18/2013
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