Provider Demographics
NPI:1912173618
Name:SOTELO, SYLVIA ANNA (LPC NCC)
Entity type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:ANNA
Last Name:SOTELO
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2046 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-4406
Mailing Address - Country:US
Mailing Address - Phone:517-263-7074
Mailing Address - Fax:
Practice Address - Street 1:2046 ALLEN ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-4406
Practice Address - Country:US
Practice Address - Phone:517-263-7074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007313101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional