Provider Demographics
NPI:1720653207
Name:HOFLAND, MISTI LEIGH (MA, CRC, CH-C)
Entity Type:Individual
Prefix:
First Name:MISTI
Middle Name:LEIGH
Last Name:HOFLAND
Suffix:
Gender:F
Credentials:MA, CRC, CH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 AVENUE C NW
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1735
Mailing Address - Country:US
Mailing Address - Phone:406-750-8875
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 336
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3243
Practice Address - Country:US
Practice Address - Phone:406-750-8875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT62172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional