Provider Demographics
NPI:1083173793
Name:PETER LETENDRE, LMHC
Entity Type:Organization
Organization Name:PETER LETENDRE, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:LETENDRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:401-226-1119
Mailing Address - Street 1:6786 BERWICK PL
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-8311
Mailing Address - Country:US
Mailing Address - Phone:401-226-1119
Mailing Address - Fax:
Practice Address - Street 1:999 N COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2773
Practice Address - Country:US
Practice Address - Phone:401-226-1119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty