Healthcare Provider Details

I. General information

NPI: 1326749060
Provider Name (Legal Business Name): THERESA ANN HOFFMANN LCPC NCC CCATP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. THERESA ANN HOFFMANN

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 03/10/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10632 LITTLE PATUXENT PKWY STE 130
COLUMBIA MD
21044-6280
US

IV. Provider business mailing address

14317 BALD HILL CT
BURTONSVILLE MD
20866-2070
US

V. Phone/Fax

Practice location:
  • Phone: 301-641-0987
  • Fax: 301-890-8434
Mailing address:
  • Phone: 301-641-0987
  • Fax: 301-890-8434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC0565
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: