Provider Demographics
NPI:1629872106
Name:HOFER, MITCHELL D (PLMHP)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:D
Last Name:HOFER
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16934 FRANCES ST STE 101
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2397
Mailing Address - Country:US
Mailing Address - Phone:402-234-7460
Mailing Address - Fax:402-234-7460
Practice Address - Street 1:16934 FRANCES ST STE 101
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2397
Practice Address - Country:US
Practice Address - Phone:402-234-7460
Practice Address - Fax:402-234-7460
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health