Provider Demographics
NPI:1548574650
Name:HOFFMANN, JOHN JEFFRY (LISW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JEFFRY
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 OLD AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-5034
Mailing Address - Country:US
Mailing Address - Phone:803-522-2972
Mailing Address - Fax:
Practice Address - Street 1:640 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-5034
Practice Address - Country:US
Practice Address - Phone:803-522-2972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC121661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical