Healthcare Provider Details

I. General information

NPI: 1285215905
Provider Name (Legal Business Name): KATIE LOU HOEFER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N WASHINGTON ST STE 232
FARMINGTON MO
63640-1702
US

IV. Provider business mailing address

400 DOUGLAS DR APT J
PARK HILLS MO
63601-2293
US

V. Phone/Fax

Practice location:
  • Phone: 573-756-6444
  • Fax:
Mailing address:
  • Phone: 573-210-8940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2020043292
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2013022739
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: