MEDICARE: TERRI PENDLETON LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH-3827	FL
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1942386024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI PENDLETON LMHC

Provider Business Mailing Address
First Line	:	13700 LITTLE RD # 3001
Second Line	:
City	:	HUDSON
State	:	FL
Zip	:	34667-8024
Country	:	US
Telephone Number	:	727-785-7472
Fax Number	:	727-785-7429

Provider Business Practice Location Address
First Line	:	13700 LITTLE RD # 3001
Second Line	:
City	:	HUDSON
State	:	FL
Zip	:	34667-8024
Country	:	US
Telephone Number	:	727-785-7472
Fax Number	:	727-785-7429

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	03/03/2025

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