Provider Demographics
NPI:1669921219
Name:HOFFMAN, LISA SUN (LPC, MA, LAC, MAC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:SUN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LPC, MA, LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6547 N ACADEMY BLVD # 1166
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8342
Mailing Address - Country:US
Mailing Address - Phone:516-243-7803
Mailing Address - Fax:
Practice Address - Street 1:3470 BRIARGATE BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-4168
Practice Address - Country:US
Practice Address - Phone:516-243-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0012518101YP2500X
COACD.0001616101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)