Provider Demographics
NPI:1124454046
Name:HOFMEISTER, LINNEA ELLEN (LCSW, LADC, CCS)
Entity type:Individual
Prefix:MRS
First Name:LINNEA
Middle Name:ELLEN
Last Name:HOFMEISTER
Suffix:
Gender:F
Credentials:LCSW, LADC, CCS
Other - Prefix:
Other - First Name:LINNEA
Other - Middle Name:ELLEN
Other - Last Name:THRASHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 OAK STREET
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5118
Mailing Address - Country:US
Mailing Address - Phone:888-922-4736
Mailing Address - Fax:844-331-2315
Practice Address - Street 1:49 OAK ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-542-4301
Practice Address - Fax:207-626-8312
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC5357101YA0400X
MECAC4843101YA0400X
MECCS6972101YA0400X
MEMC168471041C0700X
MELC18368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEVC2199209651Medicaid