Provider Demographics
NPI:1134472061
Name:HOFFMAN, AMIE (LCSW)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1635
Mailing Address - Country:US
Mailing Address - Phone:570-373-3332
Mailing Address - Fax:
Practice Address - Street 1:1908 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1635
Practice Address - Country:US
Practice Address - Phone:570-337-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW126347104100000X
PACW0175181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker