Provider Demographics
NPI:1174881841
Name:HOFFLER-DUCKWORTH, LAVERNE (SW)
Entity type:Individual
Prefix:
First Name:LAVERNE
Middle Name:
Last Name:HOFFLER-DUCKWORTH
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GERMANTOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1800
Mailing Address - Country:US
Mailing Address - Phone:267-781-5759
Mailing Address - Fax:
Practice Address - Street 1:325 SENTRY PKWY E BLDG 5
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2312
Practice Address - Country:US
Practice Address - Phone:267-481-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPCO10820101YP2500X
PAPC010820101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional