Provider Demographics
NPI:1386821098
Name:SOUTO, PRISCILLA J (LPC)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:J
Last Name:SOUTO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 W PALMETTO PARK RD STE 106
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3760
Mailing Address - Country:US
Mailing Address - Phone:954-732-4804
Mailing Address - Fax:
Practice Address - Street 1:399 W PALMETTO PARK RD STE 106
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-3760
Practice Address - Country:US
Practice Address - Phone:954-732-4804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YP2500X
VA0701004317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional