Healthcare Provider Details

I. General information

NPI: 1942386024
Provider Name (Legal Business Name): TERRI PENDLETON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13700 LITTLE RD # 3001
HUDSON FL
34667-8024
US

IV. Provider business mailing address

13700 LITTLE RD # 3001
HUDSON FL
34667-8024
US

V. Phone/Fax

Practice location:
  • Phone: 727-785-7472
  • Fax: 727-785-7429
Mailing address:
  • Phone: 727-785-7472
  • Fax: 727-785-7429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH-3827
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: