Healthcare Provider Details

I. General information

NPI: 1144933284
Provider Name (Legal Business Name): JOSHUA HOFFMAN LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2023
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 W EMERALD ST
BOISE ID
83704-8738
US

IV. Provider business mailing address

1650 S TOPAZ WAY
MERIDIAN ID
83642-4474
US

V. Phone/Fax

Practice location:
  • Phone: 208-609-9020
  • Fax:
Mailing address:
  • Phone: 208-605-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number430778
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: