Healthcare Provider Details

I. General information

NPI: 1881712081
Provider Name (Legal Business Name): CONNIE HOFMEISTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 RESEARCH DR STE 100
WOODLAND PARK CO
80863-9733
US

IV. Provider business mailing address

PO BOX 1822
WOODLAND PARK CO
80866-1822
US

V. Phone/Fax

Practice location:
  • Phone: 719-330-4747
  • Fax:
Mailing address:
  • Phone: 719-687-2620
  • Fax: 719-687-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number991305
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: