Healthcare Provider Details

I. General information

NPI: 1679628572
Provider Name (Legal Business Name): LAURA ELLEN HOFFMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA HOFFMAN MELTZER MSW,LCSWE

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 CHURCH RD STE 202
CHERRY HILL NJ
08002-1460
US

IV. Provider business mailing address

310 OSPREY LN
VOORHEES NJ
08043-1620
US

V. Phone/Fax

Practice location:
  • Phone: 215-808-2631
  • Fax:
Mailing address:
  • Phone: 215-808-2631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014330
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: