Provider Demographics
NPI:1124107743
Name:VERDESOTO, PILAR M (LCSW R)
Entity type:Individual
Prefix:MRS
First Name:PILAR
Middle Name:M
Last Name:VERDESOTO
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 HILLTOP ROAD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598
Mailing Address - Country:US
Mailing Address - Phone:914-245-9044
Mailing Address - Fax:914-245-3091
Practice Address - Street 1:3651 HILL BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535
Practice Address - Country:US
Practice Address - Phone:914-245-3091
Practice Address - Fax:914-245-3091
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03919511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0086863JMedicaid
NYW4L651Medicare ID - Type Unspecified