Individual provider Active NPI

Tammy Lee Hofer, LPC

  • Professional Counselor
  • Kirkwood, MO
National Provider Identifier
1639319668
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2003015573 Issued in MO
Practice address
#140 Prospect Ave Ste. T
Kirkwood, MO 63122
Phone
(314) 200-4482
Fax
(314) 576-7319
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2003015573 MO Primary

Addresses

Primary practice location

#140 Prospect Ave Ste. T
Kirkwood, MO 63122

Mailing address

14377 Woodlake Dr
Chesterfield, MO 63017-5735
Phone (314) 576-6493

Other names 1

  • Ms. Tammy Lee Johnston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2003015573MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elephant Rock Counseling, LLC CurrentSince Mar 24, 2024 Accepting new patients

Locations

140 Prospect Ave
Ste T
Kirkwood, MO 63122
Phone (314) 200-4482

Organizations & group practices 1

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": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1639319668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-576-6493",
            "fax_number": "314-576-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#140 PROSPECT AVE STE. T",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "63122",
            "telephone_number": "314-200-4482",
            "fax_number": "314-576-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFER",
        "first_name": "TAMMY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2003015573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "JOHNSTON",
            "middle_name": "LEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.