Healthcare Provider Details

I. General information

NPI: 1205576881
Provider Name (Legal Business Name): LORI RENEE HOFFMAN BARNHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 NEWARK POMPTON TPKE
POMPTON PLAINS NJ
07444-1735
US

IV. Provider business mailing address

PO BOX 336
POMPTON PLAINS NJ
07444-0336
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-2700
  • Fax: 973-839-2701
Mailing address:
  • Phone: 973-839-2700
  • Fax: 973-839-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00016200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: