Healthcare Provider Details

I. General information

NPI: 1881848802
Provider Name (Legal Business Name): KATHRYN G. HOFFMEISTER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN G. KOCHERSBERGER

II. Dates (important events)

Enumeration Date: 11/05/2008
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47-49 STOCKTON AVENUE
WALTON NY
13856
US

IV. Provider business mailing address

47-49 STOCKTON AVENUE
WALTON NY
13856
US

V. Phone/Fax

Practice location:
  • Phone: 607-865-4116
  • Fax: 607-865-8568
Mailing address:
  • Phone: 607-865-4116
  • Fax: 607-865-8568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number080517LCSW
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: