Provider Demographics
NPI:1225518590
Name:HOFMANN, ROSEMARIE ANGELINE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:ANGELINE
Last Name:HOFMANN
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 1:738 SMITHTOWN BYP STE 108
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5015
Mailing Address - Country:US
Mailing Address - Phone:631-624-0793
Mailing Address - Fax:
Practice Address - Street 1:738 SMITHTOWN BYP STE 108
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5015
Practice Address - Country:US
Practice Address - Phone:631-624-0793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0866101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical