Provider Demographics
NPI:1023610573
Name:SOFFE, EDWARD JOHN (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOHN
Last Name:SOFFE
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11621 OLD FORGE RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-8771
Mailing Address - Country:US
Mailing Address - Phone:301-573-2800
Mailing Address - Fax:
Practice Address - Street 1:113 S PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5409
Practice Address - Country:US
Practice Address - Phone:301-573-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical