Provider Demographics
NPI:1639247919
Name:HOFFMANN, BONNIE LYNN (MS, LMHC, NBCCH)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LYNN
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:MS, LMHC, NBCCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 KINGFISHER RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2145
Mailing Address - Country:US
Mailing Address - Phone:516-236-4577
Mailing Address - Fax:516-796-6062
Practice Address - Street 1:1400 WANTAGH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-2257
Practice Address - Country:US
Practice Address - Phone:516-236-4577
Practice Address - Fax:516-796-6062
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000133-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health