Provider Demographics
NPI:1871257014
Name:HOFMAN, JUANITA (LCSW)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:
Last Name:HOFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18924 CREEKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-9496
Mailing Address - Country:US
Mailing Address - Phone:708-267-2199
Mailing Address - Fax:
Practice Address - Street 1:4318 S STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-3701
Practice Address - Country:US
Practice Address - Phone:773-245-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical