Healthcare Provider Details

I. General information

NPI: 1346658804
Provider Name (Legal Business Name): MEGAN HOFFMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN KOTT LPC

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 GREENWOOD AVE
JACKSON MI
49203-3037
US

IV. Provider business mailing address

5669 HUNTINGTON CT
YPSILANTI MI
48197-7127
US

V. Phone/Fax

Practice location:
  • Phone: 517-998-4673
  • Fax:
Mailing address:
  • Phone: 517-240-6082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401014415
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: