Provider Demographics
NPI:1871629899
Name:HOFFMAN, BETH A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:A
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 1:11050 71ST RD
Mailing Address - Street 2:1K
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4969
Mailing Address - Country:US
Mailing Address - Phone:718-390-8922
Mailing Address - Fax:718-225-1538
Practice Address - Street 1:11050 71ST RD
Practice Address - Street 2:1K
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4969
Practice Address - Country:US
Practice Address - Phone:718-390-8922
Practice Address - Fax:718-225-1538
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0301271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7404356OtherGHI-VALUE OPTIONS
NYP590788OtherOXFORD HEALTH PLANS
NY01887Medicare ID - Type Unspecified