Provider Demographics
NPI:1184436867
Name:SOMA CULTURA
Entity type:Organization
Organization Name:SOMA CULTURA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ VIVES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:734-249-9898
Mailing Address - Street 1:4860 WASHTENAW AVE STE I398
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3401
Mailing Address - Country:US
Mailing Address - Phone:734-249-9898
Mailing Address - Fax:
Practice Address - Street 1:4860 WASHTENAW AVE STE I398
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3401
Practice Address - Country:US
Practice Address - Phone:734-249-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty