Healthcare Provider Details

I. General information

NPI: 1184983280
Provider Name (Legal Business Name): MICHAEL HOFMAIER LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 01/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 SW SAINT LUCIE CRES STE 107
STUART FL
34994-2851
US

IV. Provider business mailing address

607 SW SAINT LUCIE CRES STE 107
STUART FL
34994-2851
US

V. Phone/Fax

Practice location:
  • Phone: 772-631-0591
  • Fax: 772-678-6428
Mailing address:
  • Phone: 772-631-0591
  • Fax: 772-678-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: