Provider Demographics
NPI:1659653178
Name:LETTINGTON, MATTHEW WESLEY (MA, MFT)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:WESLEY
Last Name:LETTINGTON
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 MIDDLE RD
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7600
Mailing Address - Country:US
Mailing Address - Phone:563-554-9140
Mailing Address - Fax:
Practice Address - Street 1:1912 MIDDLE RD
Practice Address - Street 2:SUITE 300A
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7600
Practice Address - Country:US
Practice Address - Phone:563-554-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000340106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist