Healthcare Provider Details

I. General information

NPI: 1588892012
Provider Name (Legal Business Name): DIANE R. DOLAN-SOTO MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EASTOWNE DR
CHAPEL HILL NC
27514-2286
US

IV. Provider business mailing address

100 EASTOWNE DR
CHAPEL HILL NC
27514-2286
US

V. Phone/Fax

Practice location:
  • Phone: 919-564-9870
  • Fax: 984-974-6164
Mailing address:
  • Phone: 919-564-9870
  • Fax: 984-974-6164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC006016
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0530641
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: