Provider Demographics
NPI:1407268998
Name:VERDESOTO, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:VERDESOTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:ELIZABETH
Other - Last Name:VERDESOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:502 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5549
Mailing Address - Country:US
Mailing Address - Phone:718-401-6030
Mailing Address - Fax:
Practice Address - Street 1:502 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5549
Practice Address - Country:US
Practice Address - Phone:718-401-6030
Practice Address - Fax:718-401-6033
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0867971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical