Provider Demographics
NPI:1902001845
Name:HOFFMAN, CHAD R (MA, TLMFT)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MA, TLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14570 W 151ST TER
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-3728
Mailing Address - Country:US
Mailing Address - Phone:913-515-6966
Mailing Address - Fax:913-764-4160
Practice Address - Street 1:13839 S MUR LEN RD
Practice Address - Street 2:SUITE K
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1652
Practice Address - Country:US
Practice Address - Phone:913-764-5463
Practice Address - Fax:913-764-4160
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS747106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist