Healthcare Provider Details

I. General information

NPI: 1700293941
Provider Name (Legal Business Name): DAMIEN HOFFMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E HANOVER AVE STE 203
CEDAR KNOLLS NJ
07927-2047
US

IV. Provider business mailing address

200 HILLSIDE AVE
CHATHAM NJ
07928-1926
US

V. Phone/Fax

Practice location:
  • Phone: 973-219-1676
  • Fax:
Mailing address:
  • Phone: 973-219-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05590500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: