Provider Demographics
NPI:1245451871
Name:LETENDRE, PETER C (MA, CAGS, LMHC, LMHC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:C
Last Name:LETENDRE
Suffix:
Gender:M
Credentials:MA, CAGS, LMHC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12272 TAMIAMI TRL E STE 402
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-7950
Mailing Address - Country:US
Mailing Address - Phone:239-919-3127
Mailing Address - Fax:
Practice Address - Street 1:12272 TAMIAMI TRL E STE 402
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-7950
Practice Address - Country:US
Practice Address - Phone:239-919-3127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP-351101YA0400X
RIMHC00413101YM0800X
FLMH16434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)