Healthcare Provider Details

I. General information

NPI: 1780400150
Provider Name (Legal Business Name): SARAH HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH IANDOLI

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST UNIT 215
MEDWAY MA
02053-1584
US

IV. Provider business mailing address

4 COLONIAL DR
NORTON MA
02766-2604
US

V. Phone/Fax

Practice location:
  • Phone: 978-505-2952
  • Fax:
Mailing address:
  • Phone: 774-270-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10003227
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: