Healthcare Provider Details

I. General information

NPI: 1669868394
Provider Name (Legal Business Name): KATY HOFFMAN BA, MS, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATY PENCE BA, MS, LPCC

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4339 WINSTON AVENUE LATONIA CENTER
COVINGTON KY
41015
US

IV. Provider business mailing address

4339 WINSTON AVENUE LATONIA CENTER
COVINGTON KY
41015
US

V. Phone/Fax

Practice location:
  • Phone: 859-835-2573
  • Fax: 859-727-6327
Mailing address:
  • Phone: 859-835-2573
  • Fax: 859-727-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number175349
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: