Healthcare Provider Details

I. General information

NPI: 1275142234
Provider Name (Legal Business Name): LEANN DEHOFF, PHD, LMHC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 10/16/2020
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S PINE ISLAND ROAD SUITE 300, UNIT 94
PLANTATION FL
33324
US

IV. Provider business mailing address

150 S PINE ISLAND ROAD SUITE 300, UNIT 94
PLANTATION FL
33324
US

V. Phone/Fax

Practice location:
  • Phone: 954-860-3742
  • Fax: 954-901-2767
Mailing address:
  • Phone: 954-860-3742
  • Fax: 954-901-2767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LEANN DEHOFF
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 954-860-3742