Provider Demographics
NPI:1285940809
Name:HOFFMAN, MELINDA KAYE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:KAYE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 SANTIAGO RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3957
Mailing Address - Country:US
Mailing Address - Phone:410-997-0996
Mailing Address - Fax:410-964-2237
Practice Address - Street 1:10928 ROCK COAST RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2735
Practice Address - Country:US
Practice Address - Phone:410-997-0996
Practice Address - Fax:410-964-2237
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1123101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional