Provider Demographics
NPI:1659955367
Name:HOFFPAUIR, RANDOLPH ELLIS (LCSW)
Entity Type:Individual
Prefix:
First Name:RANDOLPH
Middle Name:ELLIS
Last Name:HOFFPAUIR
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-0130
Mailing Address - Country:US
Mailing Address - Phone:302-448-9006
Mailing Address - Fax:
Practice Address - Street 1:109 SAVANNAH RD APT 8
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1483
Practice Address - Country:US
Practice Address - Phone:302-448-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00017611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty