Provider Demographics
NPI:1275064032
Name:HOFFMAN, BENJAMIN RICHARD (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:RICHARD
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12623 ECKEL JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1304
Mailing Address - Country:US
Mailing Address - Phone:419-262-9570
Mailing Address - Fax:
Practice Address - Street 1:12623 ECKEL JUNCTION RD
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1304
Practice Address - Country:US
Practice Address - Phone:419-262-9570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1700235104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker