Provider Demographics
NPI:1356821599
Name:HOFFMAN, AMY RENEE (LSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RENEE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 EISENHOWER BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3262
Mailing Address - Country:US
Mailing Address - Phone:814-269-1494
Mailing Address - Fax:814-266-8572
Practice Address - Street 1:1360 EISENHOWER BLVD STE 504
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3341
Practice Address - Country:US
Practice Address - Phone:814-262-7140
Practice Address - Fax:814-262-7169
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128924104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker