Healthcare Provider Details

I. General information

NPI: 1912702770
Provider Name (Legal Business Name): ELIZABETH ANNE HOFFMAN LCPC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MAIN ST STE 208
WATERVILLE ME
04901-6691
US

IV. Provider business mailing address

88 MAIN ST STE 208
WATERVILLE ME
04901-6691
US

V. Phone/Fax

Practice location:
  • Phone: 207-200-7866
  • Fax:
Mailing address:
  • Phone: 207-200-7688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL7904
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: