Provider Demographics
NPI:1871267518
Name:HOFFACKER, KIERSEN (LCSW)
Entity type:Individual
Prefix:
First Name:KIERSEN
Middle Name:
Last Name:HOFFACKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ATHENS WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1351
Mailing Address - Country:US
Mailing Address - Phone:615-320-1155
Mailing Address - Fax:
Practice Address - Street 1:1431 MOHAWK TRL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5605
Practice Address - Country:US
Practice Address - Phone:717-451-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000012955104100000X
TN90181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker