Healthcare Provider Details

I. General information

NPI: 1922586999
Provider Name (Legal Business Name): KELLY MARIE HOFFMAN ACMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MARIE HOFFMAN

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7670 W LAKE MEAD BLVD STE 135
LAS VEGAS NV
89128-6651
US

IV. Provider business mailing address

7670 W LAKE MEAD BLVD STE 135
LAS VEGAS NV
89128-6651
US

V. Phone/Fax

Practice location:
  • Phone: 702-930-2009
  • Fax:
Mailing address:
  • Phone: 702-930-2009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: