Healthcare Provider Details

I. General information

NPI: 1629993720
Provider Name (Legal Business Name): MADDISON ANN HOFMANN MA, LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4720 NATIONS CROSSING RD
CHARLOTTE NC
28217-1801
US

IV. Provider business mailing address

4720 NATIONS CROSSING RD APT 463
CHARLOTTE NC
28217-2327
US

V. Phone/Fax

Practice location:
  • Phone: 704-389-0508
  • Fax:
Mailing address:
  • Phone: 704-389-0508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP024207
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: