Healthcare Provider Details

I. General information

NPI: 1639312648
Provider Name (Legal Business Name): REBECCA LYNN HOFFMANN-SPEARS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 W TUNNEL BLVD SUITE 200
HOUMA LA
70360-2801
US

IV. Provider business mailing address

1340 W TUNNEL BLVD SUITE 212
HOUMA LA
70360-2801
US

V. Phone/Fax

Practice location:
  • Phone: 985-853-8550
  • Fax: 985-853-8559
Mailing address:
  • Phone: 985-853-8550
  • Fax: 985-853-8559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8065
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: