| Robert C. Pennebaker Pllc | |
|
2931 Breezewood Ave Ste 104 Fayetteville NC 28303-5281 | |
| (910) 491-1134 | |
| (910) 491-1332 |
| Full Name | Robert C. Pennebaker Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2931 Breezewood Ave Ste 104, Fayetteville, North Carolina |
| Authorized Official Name and Position | Robert Christopher Pennebaker (PRESIDENT) |
| Authorized Official Contact | 9109771396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert C. Pennebaker Pllc 5774 Waters Edge Dr Fayetteville NC 28314-1055 Ph: (910) 977-1396 | Robert C. Pennebaker Pllc 2931 Breezewood Ave Ste 104 Fayetteville NC 28303-5281 Ph: (910) 491-1134 |
| NPI Number | 1144657677 |
|---|---|
| Provider Enumeration Date | 09/30/2013 |
| Last Update Date | 11/30/2020 |
| Certification Date | 11/30/2020 |
| Medicare PECOS PAC ID | 3870802010 |
|---|---|
| Medicare Enrollment ID | O20151029000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144657677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | C002032 (North Carolina) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 5005524 (North Carolina) | Primary |
| Provider Name | Robert C Pennebaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609957505 PECOS PAC ID: 2567637184 Enrollment ID: I20151029000414 |
| Provider Name | Ashley G Clocher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891121372 PECOS PAC ID: 3173833902 Enrollment ID: I20151107000128 |
| Provider Name | Sue E Hunt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932507159 PECOS PAC ID: 2062848922 Enrollment ID: I20200212002567 |
| Provider Name | Bonney L Wheelden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720267925 PECOS PAC ID: 0143465674 Enrollment ID: I20220310002974 |
| Provider Name | Danyelle Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184336893 PECOS PAC ID: 0840664991 Enrollment ID: I20230817003272 |
| Provider Name | Tyra Oxendine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700493228 PECOS PAC ID: 8729430616 Enrollment ID: I20240116003330 |
| Provider Name | Michael Carroll |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811443187 PECOS PAC ID: 0648547000 Enrollment ID: I20240122000976 |
| Provider Name | Denise Downing Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336321298 PECOS PAC ID: 7113366048 Enrollment ID: I20240411002941 |
| Provider Name | Gigi Andrews Ritchey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114466554 PECOS PAC ID: 8426589979 Enrollment ID: I20241008002152 |
| Provider Name | Martha Kerubo Ochako |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497417844 PECOS PAC ID: 0547792525 Enrollment ID: I20241015003319 |
Mid-south Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 Hope Mills Rd, Fayetteville, NC 28304 Phone: 757-541-4816 | |
A Work In Progress Therapies, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 915 Bingham Dr, Fayetteville, NC 28304 Phone: 910-483-8713 Fax: 910-483-0962 | |
Nc Therapy And Counseling Services Pa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 916 Arsenal Ave Ste B, Fayetteville, NC 28305 Phone: 910-263-5475 | |
Johari Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Whitfield St, Fayetteville, NC 28306 Phone: 910-897-3000 | |
Catholic Charities Of The Diocese Of Raleigh, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2712 Fort Bragg Rd, Fayetteville, NC 28303 Phone: 910-424-2020 | |
Carolina Children Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7712 N Ancon Dr, Fayetteville, NC 28304 Phone: 910-778-8125 | |
Living Waters Group Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8383 Cliffdale Rd, Fayetteville, NC 28314 Phone: 910-717-6127 Fax: 910-339-1844 |