Healthcare Provider Details

I. General information

NPI: 1396272217
Provider Name (Legal Business Name): LAUREN CATHERINE HOFMEISTER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 E 46TH ST
MINNEAPOLIS MN
55407-3562
US

IV. Provider business mailing address

1121 E 46TH ST
MINNEAPOLIS MN
55407-3562
US

V. Phone/Fax

Practice location:
  • Phone: 612-204-8278
  • Fax: 612-827-9325
Mailing address:
  • Phone: 612-204-8278
  • Fax: 612-827-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23406
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: