Healthcare Provider Details

I. General information

NPI: 1164671913
Provider Name (Legal Business Name): THOMAS DAVID HOFFPAUIR JR. LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: THOMAS DAVID HOFFPAUIR JR. LMSW

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR BLDG 1701K108
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

326 BROWN ST
LITTLE ROCK AR
72205-5843
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3490
  • Fax:
Mailing address:
  • Phone: 501-658-3729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1041C0700X
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: