Martha Lilia Soto Ceballos, LCSW, ASUDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10378394-3502 Issued in UT

Practice address

4000 S 700 E Ste 9
Salt Lake City, UT 84107-2581

Phone

(801) 639-9544

NPI assigned

Jan 27, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inclusive Minded Counseling & Consulting, LLC

  • Clinical Social Worker
  • South Salt Lake, UT
  • NPI 1104643501
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1114558376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5481 W RIDGE HOLLOW WAY",
            "city": "KEARNS",
            "state": "UT",
            "postal_code": "841189251",
            "telephone_number": "385-414-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 9",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072581",
            "telephone_number": "801-639-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO CEBALLOS",
        "first_name": "MARTHA",
        "middle_name": "LILIA",
        "credential": "LCSW, ASUDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-27",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "10378394-3502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.cccslc.com",
            "affiliation": "N",
            "endpointDescription": "Work URL",
            "address_1": "4000 S 700 E Ste 9",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841072581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael J Sossenheimer, M.D.
• Aldito Sotelo
• Christopher Gus Sotiriou, PHARM.D., MBA
• Leo Sotiriou, MD
• Michael Sotiriou, M.D.
• Ailin G Soto
• Danielle Shea Soto, PA
• Julya Marie Anderson Soto
• Valencia Soto
• Bahman Sotoodian, MD, FRCP(C), FAAD

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.