Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Robert Pennebaker, PMHNP-BC, LCSW

Individual provider Clinical Social Worker · NPI 1609957505

Robert Pennebaker, PMHNP-BC, LCSW is a Nurse Practitioner in Fayetteville, North Carolina. Qualified in 2011, 15 years ago. Practices with Robert C Pennebaker PLLC, a 9-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
15
Licensed in
NC
In the registry since
2006
Specialties on file
2
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2931 Breezewood Ave Ste 104
Fayetteville, NC 28303-5281
Phone: (910) 491-1134
Fax: (910) 491-9781
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5005524 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence C002032 (NC)

Record details

NPI number1609957505
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNP-BC , LCSW
Sole proprietorYes
NPI enumeratedOctober 18, 2006
Last updated in NPPESSeptember 24, 2020
Certification dateSeptember 24, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Robert C Pennebaker Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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