Healthcare Provider Details

I. General information

NPI: 1477730703
Provider Name (Legal Business Name): ALEXIS CATHARINE HOFKER PLMHP, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 09/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W BROADWAY
COUNCIL BLUFFS IA
51503-9078
US

IV. Provider business mailing address

300 W BROADWAY STE 107
COUNCIL BLUFFS IA
51503-4489
US

V. Phone/Fax

Practice location:
  • Phone: 712-328-3700
  • Fax: 712-328-3721
Mailing address:
  • Phone: 712-328-3700
  • Fax: 712-328-3721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8522
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001306
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: