Provider Demographics
NPI:1336862630
Name:LETOURNEAU, SAMANTHA (MHC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LETOURNEAU
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1898
Mailing Address - Country:US
Mailing Address - Phone:508-510-1371
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1898
Practice Address - Country:US
Practice Address - Phone:508-510-1371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health