MEDICARE: MS. JUDITH LYNN HOFFMAN MSW, LISW-CP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	72	SC
2	104100000X	Social Worker	#72	SC

General Provider Information

NPI Number	:	1043284623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH LYNN HOFFMAN MSW, LISW-CP

Provider Business Mailing Address
First Line	:	9263-A MEDICAL PLAZA DRIVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406
Country	:	US
Telephone Number	:	843-209-0961
Fax Number	:	843-884-4019

Provider Business Practice Location Address
First Line	:	9263-A MEDICAL PLAZA DRIVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406
Country	:	US
Telephone Number	:	843-209-0961
Fax Number	:	843-884-4019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	11/27/2016

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