Kevin Dale Hofstetter, MA LPCC
Individual provider Active NPI Professional Counselor · Perrysville, OH
NPI 1144470485 · NPPES record last updated Mar 4, 2019
Key facts
- NPI
- 1144470485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- E.0008406 (OH)
- Practice address
- 1012 Odnr Mohican 51
Perrysville, OH 44864 - Phone
- (419) 994-0300
- NPI assigned
- Sep 23, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2004
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2587 Back Orrville Rd
Wooster, OH 44691-9523
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260504005553 | OH | Practitioner - Mental Health Counselor | 5890263305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.0008406 | OH | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E.0008406 | OH | Yes |
Addresses
Primary practice location
1012 Odnr Mohican 51
Perrysville, OH 44864
Mailing address
1012 Odnr Mohican 51
Perrysville, OH 44864-9407
Phone (419) 994-0300
Other practice location 1
1012 Odnr Mohican 51
Perrysville, OH 44864
Phone (419) 994-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0227403 | Medicaid | OH |
Other providers in Perrysville, OH
- Nathaniel Hammond
- Glynis Anne Haney
- Hannah Harding
- Damon Harris
- Heather Hoffman
- James Grant Hollenbach
- Leshun Holmes
- Heidi Ingram
- Courtney Jarvis
- Nathaniel M Johnson
All providers in Perrysville, OH · Professional Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.