Provider Demographics
NPI:1639395106
Name:LETENDRE, MARGARET A (LICSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:LETENDRE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 KING CHARLES DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871
Mailing Address - Country:US
Mailing Address - Phone:401-683-6862
Mailing Address - Fax:401-683-6113
Practice Address - Street 1:11 KING CHARLES DRIVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871
Practice Address - Country:US
Practice Address - Phone:401-683-6862
Practice Address - Fax:401-683-6113
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW00809103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy