Provider Demographics
NPI:1871504936
Name:HOFFMAN, NANCY E (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:HOFFMAN
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:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-0042
Mailing Address - Country:US
Mailing Address - Phone:541-390-3299
Mailing Address - Fax:541-548-6501
Practice Address - Street 1:2542 NE COURTNEY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7685
Practice Address - Country:US
Practice Address - Phone:541-322-2768
Practice Address - Fax:541-322-4760
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL32621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR114207Medicare ID - Type Unspecified