MEDICARE: RICHARD HOFFMAN PHD

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	101YM0800X	Mental Health Counselor	011479-01	NY
2	101YP2500X	Professional Counselor	E.1800770-SUPV	OH
3	103TC1900X	Counseling Psychologist	PC001988	PA
4	101YP2500X	Professional Counselor	PC001988	PA

General Provider Information

NPI Number	:	1538222534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD HOFFMAN PHD

Provider Business Mailing Address
First Line	:	101 PEMBROKE CT
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6404
Country	:	US
Telephone Number	:	724-396-1510
Fax Number	:	724-836-2876

Provider Business Practice Location Address
First Line	:	438 PELLIS RD STE 202
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-7900
Country	:	US
Telephone Number	:	724-396-1510
Fax Number	:	724-972-4627

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	11/08/2021

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