Provider Demographics
NPI:1568789386
Name:HOFFMAN, KRISTEN M (LISW)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45015
Mailing Address - Country:US
Mailing Address - Phone:513-867-5654
Mailing Address - Fax:513-867-5669
Practice Address - Street 1:2100 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015
Practice Address - Country:US
Practice Address - Phone:513-868-1562
Practice Address - Fax:513-868-1415
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.09001161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI.0900116OtherLISW