Healthcare Provider Details

I. General information

NPI: 1285940809
Provider Name (Legal Business Name): MELINDA KAYE HOFFMAN LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2010
Last Update Date: 08/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10928 ROCK COAST RD
COLUMBIA MD
21044-2735
US

IV. Provider business mailing address

9650 SANTIAGO RD SUITE 3
COLUMBIA MD
21045-3957
US

V. Phone/Fax

Practice location:
  • Phone: 410-997-0996
  • Fax: 410-964-2237
Mailing address:
  • Phone: 410-997-0996
  • Fax: 410-964-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC1123
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: