Provider Demographics
NPI:1508993890
Name:HOFFMAN, LESLIE SUE (MSSW LMFT LCSW)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:SUE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MSSW LMFT LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 SPICEWOOD SPRINGS RD
Mailing Address - Street 2:BUILDING 4 SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8598
Mailing Address - Country:US
Mailing Address - Phone:512-231-0164
Mailing Address - Fax:512-467-8658
Practice Address - Street 1:4601 SPICEWOOD SPRINGS RD
Practice Address - Street 2:BUILDING 4 SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8598
Practice Address - Country:US
Practice Address - Phone:512-231-0164
Practice Address - Fax:512-467-8658
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX050821041C0700X
TX3963106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSW00S21E6Medicaid
TXSW00S21E6Medicaid