Healthcare Provider Details

I. General information

NPI: 1679551360
Provider Name (Legal Business Name): TIMOTHY C. HOFFMAN PH.D., L.M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TIMOTHY C. HOFFMAN PH.D., L.M.F.T.

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 PAXTON RD
SPENCER MA
01562-1515
US

IV. Provider business mailing address

67 PAXTON RD
SPENCER MA
01562-1515
US

V. Phone/Fax

Practice location:
  • Phone: 508-885-6495
  • Fax:
Mailing address:
  • Phone: 508-885-6495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1007
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: