Provider Demographics
NPI:1588713903
Name:TENTHOFF, ALAN PETER (MS, LMHCS)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:PETER
Last Name:TENTHOFF
Suffix:
Gender:M
Credentials:MS, LMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-1220
Mailing Address - Country:US
Mailing Address - Phone:910-200-4324
Mailing Address - Fax:
Practice Address - Street 1:1345 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-1220
Practice Address - Country:US
Practice Address - Phone:910-200-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RT00289200101YM0800X
NCS8202101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
76-0728318OtherFEDERAL TAX ID
NC6104676Medicaid