Provider Demographics
NPI:1699372201
Name:HOFFMAN, JENNIFER (MS, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10542 W FOOTHILL DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1760
Mailing Address - Country:US
Mailing Address - Phone:602-647-5001
Mailing Address - Fax:
Practice Address - Street 1:10542 W FOOTHILL DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1760
Practice Address - Country:US
Practice Address - Phone:602-647-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19180101YM0800X
AZLPC-21798101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health