Provider Demographics
NPI:1194410761
Name:HOFFMAN, JEANINE B (LMHC)
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:B
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11125 FATHOM LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-9124
Mailing Address - Country:US
Mailing Address - Phone:317-394-0477
Mailing Address - Fax:
Practice Address - Street 1:10967 ALLISONVILLE RD STE 240
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2634
Practice Address - Country:US
Practice Address - Phone:317-558-0630
Practice Address - Fax:317-558-0631
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health