Healthcare Provider Details

I. General information

NPI: 1952111486
Provider Name (Legal Business Name): OLIVIA A HOFF-GOLMEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3395 PLYMOUTH RD
MINNETONKA MN
55305-3765
US

IV. Provider business mailing address

4650 LAKEWAY TER
EXCELSIOR MN
55331-9366
US

V. Phone/Fax

Practice location:
  • Phone: 952-210-7813
  • Fax:
Mailing address:
  • Phone: 612-532-6089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31401
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: