Provider Demographics
NPI:1538557038
Name:HOFLAND, JADA (MS-LPC)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:
Last Name:HOFLAND
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:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:REEDER
Mailing Address - State:ND
Mailing Address - Zip Code:58649-0247
Mailing Address - Country:US
Mailing Address - Phone:701-853-2795
Mailing Address - Fax:701-853-2795
Practice Address - Street 1:503 2ND AVE E
Practice Address - Street 2:
Practice Address - City:REEDER
Practice Address - State:ND
Practice Address - Zip Code:58649-4913
Practice Address - Country:US
Practice Address - Phone:701-853-2795
Practice Address - Fax:701-853-2796
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC 1174101YP2500X
ND732-9-15-12101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional