Provider Demographics
NPI:1578012266
Name:HOFBAUER, ADAM (LSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HOFBAUER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 MONUMENT RD,
Mailing Address - Street 2:BELMONT BEHAVIORAL HOSPTIAL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131
Mailing Address - Country:US
Mailing Address - Phone:215-581-5432
Mailing Address - Fax:
Practice Address - Street 1:4200 MONUMENT RD,
Practice Address - Street 2:BELMONT BEHAVIORAL HOSPTIAL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-581-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1336851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical