Provider Demographics
NPI:1336706225
Name:LATENDRESSE, DONNA BETSY (LCAT, LMHC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:BETSY
Last Name:LATENDRESSE
Suffix:
Gender:F
Credentials:LCAT, LMHC
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:ALULEMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAT, LMHC
Mailing Address - Street 1:2218 92ND ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1117
Mailing Address - Country:US
Mailing Address - Phone:917-346-1776
Mailing Address - Fax:
Practice Address - Street 1:211 E 43RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4707
Practice Address - Country:US
Practice Address - Phone:201-699-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-26
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002108101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health