Provider Demographics
NPI:1275717977
Name:SOTO, ELIZABETH M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:SOTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:PONZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5429 STEWARTBY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5737
Mailing Address - Country:US
Mailing Address - Phone:919-244-3131
Mailing Address - Fax:919-350-8509
Practice Address - Street 1:5429 STEWARTBY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-5737
Practice Address - Country:US
Practice Address - Phone:919-244-3131
Practice Address - Fax:919-350-8509
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0063081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical