Healthcare Provider Details

I. General information

NPI: 1073245528
Provider Name (Legal Business Name): DAWN A HOFFMAN M.S. , LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 N COURTENAY PKWY STE 206
MERRITT ISLAND FL
32953-4475
US

IV. Provider business mailing address

1395 N COURTENAY PKWY STE 206
MERRITT ISLAND FL
32953-4475
US

V. Phone/Fax

Practice location:
  • Phone: 321-459-1003
  • Fax: 321-459-1006
Mailing address:
  • Phone: 321-459-1003
  • Fax: 321-459-1006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: