MEDICARE: LORI RENEE HOFFMAN BARNHARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	37LC00016200	NJ

General Provider Information

NPI Number	:	1205576881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI RENEE HOFFMAN BARNHARD

Provider Business Mailing Address
First Line	:	PO BOX 336
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-0336
Country	:	US
Telephone Number	:	973-839-2700
Fax Number	:	973-839-2701

Provider Business Practice Location Address
First Line	:	640 NEWARK POMPTON TPKE
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1735
Country	:	US
Telephone Number	:	973-839-2700
Fax Number	:	973-839-2701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	03/31/2022

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