MEDICARE: ROBERT PENNEBAKER PMHNP-BC, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C002032	NC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5005524	NC

General Provider Information

NPI Number	:	1609957505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT PENNEBAKER PMHNP-BC, LCSW

Provider Business Mailing Address
First Line	:	2931 BREEZEWOOD AVE STE 104
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-5281
Country	:	US
Telephone Number	:	910-491-1134
Fax Number	:	910-491-9781

Provider Business Practice Location Address
First Line	:	2931 BREEZEWOOD AVE STE 104
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-5281
Country	:	US
Telephone Number	:	910-491-1134
Fax Number	:	910-491-9781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	09/24/2020

Similar Medicare Providers

1780455519 — HALEY GILES LCMHC
Practice Location Address:

2931 BREEZEWOOD AVE STE 104
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-491-1134
Practice Fax: 910-491-1332

1093716672 — MISS ELIZABETH ANN GAMBLE PSY.D.
Practice Location Address:

2931 BREEZEWOOD AVE STE 100
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-677-0000
Practice Fax: 910-677-0099

1144657677 — ROBERT C. PENNEBAKER PLLC
Practice Location Address:

2931 BREEZEWOOD AVE STE 104
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-491-1134
Practice Fax: 910-491-1332

1801202429 — ELIZABETH CALDWELL
Practice Location Address:

2931 BREEZEWOOD AVE STE 200
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-489-9036
Practice Fax:

1942744792 — CLINICAL COUNSELING AND CONSULTING SERVICES, PLLC
Practice Location Address:

2931 BREEZEWOOD AVE STE 200
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-748-0833
Practice Fax:

1053830315 — FAYETTEVILLE NEUROPSYCHOLOGY PLLC
Practice Location Address:

2931 BREEZEWOOD AVE STE 100
FAYETTEVILLE, NC
28303-5281

Practice Phone: 910-677-0000
Practice Fax: 910-677-0099

Directions to “ ROBERT PENNEBAKER PMHNP-BC, LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.