Kellie Hoffman, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6423 Issued in ND

Practice address

619 Riverwood Dr Ste 105
Bismarck, ND 58504-4304

Phone

(701) 224-9751

NPI assigned

May 24, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Decoteau Trauma-Informed Care & Practice, PLLC

  • Psychologist
  • Bismarck, ND
  • NPI 1174890016
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1023756608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 RAYMOND ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013440",
            "telephone_number": "701-426-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 RIVERWOOD DR STE 105",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585044304",
            "telephone_number": "701-224-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "KELLIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-24",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "6423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "000000000",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Lynn Hoffer, FNP-BC; NP-C
• Rick W Hofferber, CNP
• Lorraine Hoffman-Gappert
• Jacklene Hoffman, APRN, NP-C
• Joshua John Hoffman, DNP
• Toni Hoffman
• Trina Hoffman, FNP
• Rebecca Hoffmann
• Amber Rose Hoffner, QSP
• Jason Lee Hogan

• All providers in Bismarck, ND
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.