Healthcare Provider Details

I. General information

NPI: 1639247919
Provider Name (Legal Business Name): BONNIE LYNN HOFFMANN MS, LMHC, NBCCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 09/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 WANTAGH AVE SUITE 201
WANTAGH NY
11793-2257
US

IV. Provider business mailing address

73 KINGFISHER RD
LEVITTOWN NY
11756-2145
US

V. Phone/Fax

Practice location:
  • Phone: 516-236-4577
  • Fax: 516-796-6062
Mailing address:
  • Phone: 516-236-4577
  • Fax: 516-796-6062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000133-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: