Provider Demographics
NPI:1366158941
Name:DANIEL HOFMANN COUNSELING, LLC
Entity type:Organization
Organization Name:DANIEL HOFMANN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-308-1210
Mailing Address - Street 1:1818 NE IRVING ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2238
Mailing Address - Country:US
Mailing Address - Phone:503-308-1210
Mailing Address - Fax:541-805-7013
Practice Address - Street 1:1818 NE IRVING ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2238
Practice Address - Country:US
Practice Address - Phone:503-308-1210
Practice Address - Fax:541-805-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1801449319Medicaid