Healthcare Provider Details

I. General information

NPI: 1124454046
Provider Name (Legal Business Name): LINNEA ELLEN HOFMEISTER LCSW, LADC, CCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINNEA ELLEN THRASHER

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 OAK ST
AUGUSTA ME
04330
US

IV. Provider business mailing address

49 OAK STREET
AUGUSTA ME
04330-5118
US

V. Phone/Fax

Practice location:
  • Phone: 207-542-4301
  • Fax: 207-626-8312
Mailing address:
  • Phone: 888-922-4736
  • Fax: 844-331-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC5357
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC4843
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCCS6972
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC16847
License Number StateME
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC18368
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: