Provider Demographics
NPI:1194215632
Name:JANIS HOFFMAN LCSW ,PLLC
Entity type:Organization
Organization Name:JANIS HOFFMAN LCSW ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:917-596-1040
Mailing Address - Street 1:5 PRIORY CT
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3914
Mailing Address - Country:US
Mailing Address - Phone:917-596-1040
Mailing Address - Fax:
Practice Address - Street 1:2171 JERICHO TPKE STE 335
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2947
Practice Address - Country:US
Practice Address - Phone:917-596-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR058833-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty