Healthcare Provider Details

I. General information

NPI: 1831592765
Provider Name (Legal Business Name): CAROLINE HOFMANN LMHC,NBCCH, CAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 07/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3677 CENTRAL AVE STE I
FORT MYERS FL
33901-8226
US

IV. Provider business mailing address

8925 BEACON ST
FORT MYERS FL
33907-5904
US

V. Phone/Fax

Practice location:
  • Phone: 239-839-3907
  • Fax:
Mailing address:
  • Phone: 239-834-1044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAP 5050
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH14018
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: