Provider Demographics
NPI:1548479520
Name:VONHOFFMANN, IRENE KARIN (LCPC)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:KARIN
Last Name:VONHOFFMANN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SPEARIN DR
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-4246
Mailing Address - Country:US
Mailing Address - Phone:207-866-2879
Mailing Address - Fax:
Practice Address - Street 1:554 MAIN RD
Practice Address - Street 2:
Practice Address - City:EDDINGTON
Practice Address - State:ME
Practice Address - Zip Code:04428-3211
Practice Address - Country:US
Practice Address - Phone:207-843-3918
Practice Address - Fax:207-843-5807
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1630101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional