Provider Demographics
NPI:1780768218
Name:HOFFMAN, LISA SANCHO (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:SANCHO
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702
Mailing Address - Country:US
Mailing Address - Phone:631-321-0680
Mailing Address - Fax:631-661-8854
Practice Address - Street 1:193 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702
Practice Address - Country:US
Practice Address - Phone:631-321-0680
Practice Address - Fax:631-661-8854
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0566361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical