Provider Demographics
NPI:1609442896
Name:SOTO, RAQUEL MAGDALENA (LCSW)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:MAGDALENA
Last Name:SOTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 HAMILTON WOLFE RD APT 1412
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4367
Mailing Address - Country:US
Mailing Address - Phone:210-387-8067
Mailing Address - Fax:
Practice Address - Street 1:320 W 37TH ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4289
Practice Address - Country:US
Practice Address - Phone:210-387-8067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL146991041C0700X
TX652121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical