Individual provider Active NPI

Breeanna Hofmann, LCSW, LMHP

  • Clinical Social Worker
  • Rock Island, IL
National Provider Identifier
1285372375
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021124 Issued in IL
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(309) 779-2031
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 114737 IA
Clinical Social Worker 1041C0700X 149.021124 IL Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-2031

Other practice location 1

1616 Cedar St
Muscatine, IA 52761-3453
Phone (309) 779-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230111001881 IL Practitioner - Clinical Social Worker 3476923277 Reassigns benefits to 2 organizations
I20240626000102 IA Practitioner - Clinical Social Worker 3476923277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114737IAMDClinical Social Worker
149.021124ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Robert Young Center for Community Mental Health CurrentSince Jun 10, 2024 Accepting new patients
The Robert Young Center for Community Mental Health Current Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Oct 21, 2022 Accepting new patients
The Robert Young Center for Community Mental Health CurrentSince Oct 21, 2022 Accepting new patients

Locations

4622 Progress Dr
Ste A
Davenport, IA 52807
Phone (563) 742-5800

1616 Cedar St
Muscatine, IA 52761
Phone (309) 779-3000

2560 24th St
Ste 101
Rock Island, IL 61201
Phone (309) 779-3970

2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285372375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-2031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Muscatine",
            "state": "IA",
            "postal_code": "527613453",
            "country_code": "US",
            "telephone_number": "309-779-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFMANN",
        "first_name": "BREEANNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "114737",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.