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ERICA SOTO LCSW
NPI 1437431053
Social Worker - Clinical in Danbury, CT

Active since September 10, 2011PECOS Enrolled
89.4/100
CMS Quality Rating
72 NORTH ST STE 103, DANBURY, CT 06810(203) 456-3624(203) 790-0010 Get Directions Write a Review

NPPES record last updated: October 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Erica Soto Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERICA SOTO LCSW (NPI 1437431053) is an individual clinical provider in Danbury, Connecticut, licensed in Connecticut (006726) and active in the NPI registry since September 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1437431053
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameERICA SOTOCredential: LCSW
Location Address72 NORTH ST STE 103Danbury, CT 06810-5653
Mailing Address72 North St Ste 103Danbury, CT 06810-5653 · (203) 456-3624 · Fax (203) 790-0010
Phone(203) 456-3624
Fax(203) 790-0010
Sole ProprietorNo
Enumeration DateSeptember 10, 2011
Last NPPES UpdateOctober 9, 2025
NPPES CertifiedOctober 9, 2025
✔ NPI 1437431053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CT · 006726
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
72 NORTH ST STE 103, Danbury, CT 06810
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Erica Soto Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Erica Soto reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Step Up Care PC LLC
86 mi
Counselor
111 WESTCOTT RD
Danielson, CT 06239
  • Reassigned Medicare billing, Connecticut enrollment
  • 390 clinicians in this Medicare group
NPI 1154884740 (718) 298-4375

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.
49 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06810 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.82 – $183.10
Typical copayment $0.00 (range $15.20 – $45.77)
Most-billed visit code NA
Established Patient
$75.55 typical visit price
range $19.76 – $149.26
Typical copayment $18.88 (range $4.94 – $37.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

89.4/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality78.18
Improvement Activities40
Cost71.32

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH H WILLIAMS JR. M.D.
Psychiatry & Neurology (Psychiatry)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 748-1200
JANET G CUNNINGHAM
Counselor (Professional)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 464-3337
LINDSAY ELIZABETH MACRI
Nurse Practitioner (Family)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 748-1001
KAREN MARIE MULLANEY NP
Nurse Practitioner (Psychiatric/Mental Health)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 748-1200
JANET CUNNINGHAM LPC
Counselor (Professional)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (209) 792-0400
TRACEY DIANE DOLAN LCSW
Social Worker (Clinical)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 300-6553
ZAHIDA SAIRITUPA APRN-BC
Nurse Practitioner (Psychiatric/Mental Health)
72 NORTH ST STE 103
DANBURY, CT 06810
Western Connecticut Planning Region (203) 748-1200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Erica Soto's NPI number?

The NPI number for Erica Soto is 1437431053. It was assigned to this individual provider in the NPPES registry on September 10, 2011.

Where is Erica Soto located?

Erica Soto practices at 72 North St Ste 103, Danbury, CT 06810. The listed phone number is (203) 456-3624.

What is Erica Soto's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Erica Soto enrolled in Medicare?

Yes. Erica Soto is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Erica Soto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Erica Soto reassigns Medicare benefits to Step Up Care PC LLC (Danielson, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Erica Soto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Erica Soto accept?

Health plans from Anthem Blue Cross and Blue Shield list Erica Soto as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Erica Soto was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.