Provider Demographics
NPI:1396443503
Name:HOFER, JENNIFER KAY (LADC LPCC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:KAY
Last Name:HOFER
Suffix:
Gender:F
Credentials:LADC LPCC
Other - Prefix:
Other - First Name:JEN OR JENNY
Other - Middle Name:
Other - Last Name:HARROM OR KILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1174 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-4808
Mailing Address - Country:US
Mailing Address - Phone:218-770-1035
Mailing Address - Fax:651-488-0887
Practice Address - Street 1:1174 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-4808
Practice Address - Country:US
Practice Address - Phone:218-770-1035
Practice Address - Fax:651-488-0887
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305853101YA0400X
MN3717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)