Provider Demographics
NPI:1730515990
Name:HOFMANN, JORDAN MARIE (MA, PLMHP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:MARIE
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:MA, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S LOCUST ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-8200
Mailing Address - Country:US
Mailing Address - Phone:402-460-0600
Mailing Address - Fax:380-398-0351
Practice Address - Street 1:1300 S LOCUST ST
Practice Address - Street 2:SUITE F
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-8200
Practice Address - Country:US
Practice Address - Phone:402-460-0600
Practice Address - Fax:380-398-0351
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health