Provider Demographics
NPI:1962166348
Name:SOTO, NELSON (CADAC II)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:
Last Name:SOTO
Suffix:
Gender:M
Credentials:CADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 BURLINGTON WOODS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4514
Mailing Address - Country:US
Mailing Address - Phone:617-982-0181
Mailing Address - Fax:
Practice Address - Street 1:7779 E RIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-2486
Practice Address - Country:US
Practice Address - Phone:812-558-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)