MEDICARE: MRS. CAROLINE HOFMANN LMHC,NBCCH, CAP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAP 5050	FL
2	101YM0800X	Mental Health Counselor	MH14018	FL

General Provider Information

NPI Number	:	1831592765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLINE HOFMANN LMHC,NBCCH, CAP

Provider Business Mailing Address
First Line	:	8925 BEACON ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5904
Country	:	US
Telephone Number	:	239-834-1044
Fax Number	:

Provider Business Practice Location Address
First Line	:	3677 CENTRAL AVE STE I
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-8226
Country	:	US
Telephone Number	:	239-839-3907
Fax Number	:

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

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	07/28/2019

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