Healthcare Provider Details

I. General information

NPI: 1386837623
Provider Name (Legal Business Name): EDWARD JAMES HOFFMAN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 PALMETTO PARK BLVD
LEXINGTON SC
29072-7872
US

IV. Provider business mailing address

301 PALMETTO PARK BLVD
LEXINGTON SC
29072-7872
US

V. Phone/Fax

Practice location:
  • Phone: 803-359-3545
  • Fax:
Mailing address:
  • Phone:
  • 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: