Nannette Smith Funderburk, PHD, LCMHCS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5348S Issued in NC

Practice address

3612 Cranbrook Dr
Fayetteville, NC 28301-2554

Phone

(336) 285-7173

Fax

(336) 285-7174

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sel Group

  • Community/Behavioral Health Agency
  • Fayetteville, NC
  • NPI 1407012966
  Medicare reassignment NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1720131576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 BATTLEGROUND AVE STE A",
            "address_2": "PMB 266",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274081925",
            "telephone_number": "336-285-7173",
            "fax_number": "336-285-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 CRANBROOK DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283012554",
            "telephone_number": "336-285-7173",
            "fax_number": "336-285-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "NANNETTE",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "PHD, LCMHCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "5348S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zanyla Fulmore
• Gail Fulsom, PTA
• Kaniyah Fulton
• Isaura G Fumero Rivera
• Joella Fundakowski, LMBT
• Tracy L Funk, PA-C
• Cassy Funkhouser
• Dorothy Christine Funkhouser, LCSWA
• Olivia Furbush
• Yara Furstenberg, MD

• Mental Health Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.