Individual provider Active NPI

Giemaly Enid Soto, PSYD

  • Clinical Psychologist
  • Bethlehem, PA
National Provider Identifier
1730909904
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS020301 Issued in PA
Practice address
1 E Broad St Ste 510
Bethlehem, PA 18018-5964
Phone
(610) 865-4300
Fax
(610) 865-4399
NPI assigned
Oct 14, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PS020301 PA Primary

Addresses

Primary practice location

1 E Broad St Ste 510
Bethlehem, PA 18018-5964

Mailing address

415 Levee Run
Northampton, PA 18067-2102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114001952 PA Practitioner - Clinical Psychologist 2365976222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Integrated Behavioral Health, LLCGroup PAC ID 4183884521, 10 clinicians

Practice addresses (Care Compare)

1 E Broad St
Suite 510
Bethlehem, PA 18018-5964
Phone (610) 865-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrated Behavioral Health,LLC Multi-Specialty CurrentSince Oct 29, 2024 Accepting new patients

Locations

1 E Broad St
Ste 510
Bethlehem, PA 18018
Phone (610) 865-4300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1730909904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 LEVEE RUN",
            "city": "NORTHAMPTON",
            "state": "PA",
            "postal_code": "180672102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E BROAD ST STE 510",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185964",
            "telephone_number": "610-865-4300",
            "fax_number": "610-865-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO",
        "first_name": "GIEMALY",
        "middle_name": "ENID",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS020301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.