Provider Demographics
NPI:1639300866
Name:HOFFMAN, MATTHEW LEVI (MPH, LADC I, CPGS)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:LEVI
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MPH, LADC I, CPGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WINTER ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02108-4720
Mailing Address - Country:US
Mailing Address - Phone:617-482-5292
Mailing Address - Fax:617-482-5232
Practice Address - Street 1:30 WINTER ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02108-4720
Practice Address - Country:US
Practice Address - Phone:617-284-5292
Practice Address - Fax:617-482-5232
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0019101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)