Provider Demographics
NPI:1922194133
Name:HOFFMANN AND LEBEDA CHILD AND FAMILY SERVICES PLLC
Entity Type:Organization
Organization Name:HOFFMANN AND LEBEDA CHILD AND FAMILY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:LEBEDA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-421-2227
Mailing Address - Street 1:1 E MARKET ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3014
Mailing Address - Country:US
Mailing Address - Phone:703-421-2227
Mailing Address - Fax:703-443-6639
Practice Address - Street 1:1 E MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3014
Practice Address - Country:US
Practice Address - Phone:703-421-2227
Practice Address - Fax:703-443-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904004032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010215226Medicaid