Provider Demographics
NPI:1841256096
Name:HOFF, MARY A (LCPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:HOFF
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:A
Other - Last Name:HOURIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 MURRAY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1025
Mailing Address - Country:US
Mailing Address - Phone:410-235-9200
Mailing Address - Fax:410-235-9339
Practice Address - Street 1:711 W 40TH ST
Practice Address - Street 2:SUITE 456A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2120
Practice Address - Country:US
Practice Address - Phone:410-235-9200
Practice Address - Fax:410-235-9339
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401618100Medicaid