Healthcare Provider Details

I. General information

NPI: 1316351547
Provider Name (Legal Business Name): LAUREN HOFFMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 E MAIN ST STE 530
RICHMOND VA
23219-2431
US

IV. Provider business mailing address

530 E MAIN ST STE 530
RICHMOND VA
23219-2431
US

V. Phone/Fax

Practice location:
  • Phone: 804-510-0200
  • Fax: 804-482-0002
Mailing address:
  • Phone: 804-510-0200
  • Fax: 804-482-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071008840
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810005489
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: