Provider Demographics
NPI:1538475108
Name:HOFFMAN, SUSAN MARY (LMSW CAAC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LMSW CAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 STATE ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2785
Mailing Address - Country:US
Mailing Address - Phone:231-881-3970
Mailing Address - Fax:
Practice Address - Street 1:231 STATE ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2785
Practice Address - Country:US
Practice Address - Phone:231-881-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical