Healthcare Provider Details

I. General information

NPI: 1144778317
Provider Name (Legal Business Name): SHAWN HOFING LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 11/04/2023
Certification Date: 11/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 FRONT ST
LYNDEN WA
98264
US

IV. Provider business mailing address

709 FRONT ST
LYNDEN WA
98264-1819
US

V. Phone/Fax

Practice location:
  • Phone: 360-920-1696
  • Fax:
Mailing address:
  • Phone: 360-685-8114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60982468
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: