Provider Demographics
NPI:1629261979
Name:HOHFELD, WESLEY H (LADC)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:H
Last Name:HOHFELD
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SYLVIAS WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04858-3060
Mailing Address - Country:US
Mailing Address - Phone:207-594-4006
Mailing Address - Fax:
Practice Address - Street 1:474 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3344
Practice Address - Country:US
Practice Address - Phone:207-594-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC2510101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431547899Medicaid