Provider Demographics
NPI:1609926542
Name:UMHOEFER, JOSEPH T (LSW, LADC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:UMHOEFER
Suffix:
Gender:M
Credentials:LSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 TEAKWOOD LN SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1546
Mailing Address - Country:US
Mailing Address - Phone:507-529-1902
Mailing Address - Fax:
Practice Address - Street 1:923 N BROADWAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-6843
Practice Address - Country:US
Practice Address - Phone:507-281-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN301307101YA0400X
MN8762104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker