Healthcare Provider Details

I. General information

NPI: 1487535068
Provider Name (Legal Business Name): MEGAN HOFFMAN LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W7327 ANDERSON AVE
SHAWANO WI
54166-1143
US

IV. Provider business mailing address

W7327 ANDERSON AVE
SHAWANO WI
54166-1143
US

V. Phone/Fax

Practice location:
  • Phone: 715-524-6856
  • Fax:
Mailing address:
  • Phone: 715-524-6856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8656
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: