Provider Demographics
NPI:1093745911
Name:SOTO, CYNTHIA KAY (LMSW ACSW CACI)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:KAY
Last Name:SOTO
Suffix:
Gender:F
Credentials:LMSW ACSW CACI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 S TRUMBULL
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708
Mailing Address - Country:US
Mailing Address - Phone:989-922-4900
Mailing Address - Fax:989-922-4911
Practice Address - Street 1:690 S TRUMBULL
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708
Practice Address - Country:US
Practice Address - Phone:989-922-4900
Practice Address - Fax:989-922-4911
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICS068413104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008971090OtherBCBS OF MICHIGAN
9527811OtherAETNA
MI0998816OtherHEALTH PLUS
MI0998816OtherHEALTH PLUS