Provider Demographics
NPI:1639319668
Name:HOFER, TAMMY LEE (LPC)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:LEE
Last Name:HOFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:LEE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14377 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5735
Mailing Address - Country:US
Mailing Address - Phone:314-576-6493
Mailing Address - Fax:314-576-7319
Practice Address - Street 1:#140 PROSPECT AVE STE. T
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122
Practice Address - Country:US
Practice Address - Phone:314-200-4482
Practice Address - Fax:314-576-7319
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003015573101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional