Provider Demographics
NPI:1831699602
Name:HOFFMAN, SHAUN ELIZABETH (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:SHAUN
Middle Name:ELIZABETH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:SHAUN
Other - Middle Name:ELIZABETH
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1534 GREENBRIER RIDGE WAY
Mailing Address - Street 2:APT 1502
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3397
Mailing Address - Country:US
Mailing Address - Phone:865-409-1503
Mailing Address - Fax:
Practice Address - Street 1:311 DIRECTORS DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923
Practice Address - Country:US
Practice Address - Phone:865-481-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-17
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000004167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ034551Medicaid
TNQ035749Medicaid