Provider Demographics
NPI:1275872996
Name:SOTO-AYBAR, INDIRA M (LMHC)
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:M
Last Name:SOTO-AYBAR
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WATER ST APT 407
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-5017
Mailing Address - Country:US
Mailing Address - Phone:413-302-0728
Mailing Address - Fax:
Practice Address - Street 1:85 SAINT GEORGE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3333
Practice Address - Country:US
Practice Address - Phone:413-732-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA12529OtherHEALTH NEW ENGLAND
MA042622756OtherCOMMONWEALTH CARE ALLIANCE
MA71756OtherTUFTS
MA1022610OtherBEACON
MA997303OtherNETWORK HEALTH
MA1303295Medicaid
MA1303295OtherMBHP
MA8443OtherBMC/BEACON