Organization Active NPI

Penrose Creative Healing PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilmington, NC
National Provider Identifier
1457201204
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PENROSE CREATIVE HEALING PLLC
Practice address
4622 Cedar Ave Ste 122
Wilmington, NC 28403-4481
Phone
(910) 408-2558
NPI assigned
Jan 31, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pamela Penrose, LCMHCANPI 1407635543
Title
Mental Health Counselor
Phone
(910) 408-2558

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4622 Cedar Ave Ste 122
Wilmington, NC 28403-4481

Mailing address

4622 Cedar Ave Ste 122
Wilmington, NC 28403-4481

National Provider Directory

National Provider Directory

Locations

4622 Cedar Ave
Ste 122
Wilmington, NC 28403
Phone (910) 408-2558

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1457201204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4622 CEDAR AVE STE 122",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4622 CEDAR AVE STE 122",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034481",
            "telephone_number": "910-408-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENROSE CREATIVE HEALING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "PENROSE",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "910-408-2558",
        "authorized_official_credential": "LCMHCA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.