Provider Demographics
NPI:1831371145
Name:HOEFFNER, DEBBIE KIM (LCSW)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:KIM
Last Name:HOEFFNER
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 1:776 W MIDWAY RD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-4203
Mailing Address - Country:US
Mailing Address - Phone:772-323-4134
Mailing Address - Fax:
Practice Address - Street 1:776 W MIDWAY RD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-4203
Practice Address - Country:US
Practice Address - Phone:772-323-4134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-28
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 87271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW 8727OtherFLORIDA LICENSE