Provider Demographics
NPI:1922395094
Name:PETER LETENDRE & ASSOCIATES
Entity Type:Organization
Organization Name:PETER LETENDRE & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LETENDRE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LCDP
Authorized Official - Phone:401-741-3490
Mailing Address - Street 1:3047 E MAIN RD
Mailing Address - Street 2:4A
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4262
Mailing Address - Country:US
Mailing Address - Phone:401-741-3490
Mailing Address - Fax:
Practice Address - Street 1:3047 E MAIN RD
Practice Address - Street 2:4A
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4262
Practice Address - Country:US
Practice Address - Phone:401-741-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICDP351101YA0400X
RIMHC413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty