Active NPI
Andra R Soto, LCSW
- Clinical Social Worker
- Round Rock, TX
National Provider Identifier
1619385515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 103850
- Practice address
- 107 Fannin Ave Ste 100
Round Rock, TX 78664-5218 - Phone
- (737) 243-4531
- NPI assigned
- Jul 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 95969 | CA | |
| Clinical Social Worker | 1041C0700X | 103850 | TX | Primary |
Addresses
Primary practice location
107 Fannin Ave Ste 100
Round Rock, TX 78664-5218
Mailing address
107 Fannin Ave Ste 100
Round Rock, TX 78664-5218
Phone (737) 243-4531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 17, 2024 through Jan 17, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103850 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698192000000",
"number": "1619385515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 FANNIN AVE STE 100",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786645218",
"telephone_number": "737-243-4531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 FANNIN AVE STE 100",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786645218",
"telephone_number": "737-243-4531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "ANDRA",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-24",
"last_updated": "2023-10-25",
"certification_date": "2023-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "95969",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "103850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Round Rock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.