Provider Demographics
NPI:1326749060
Name:HOFFMANN, THERESA ANN (LCPC NCC CCATP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:ANN
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:LCPC NCC CCATP
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:ANN
Other - Last Name:HOFFMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:14317 BALD HILL CT
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-2070
Mailing Address - Country:US
Mailing Address - Phone:301-641-0987
Mailing Address - Fax:301-890-8434
Practice Address - Street 1:10632 LITTLE PATUXENT PKWY STE 130
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-6280
Practice Address - Country:US
Practice Address - Phone:301-641-0987
Practice Address - Fax:301-890-8434
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional