Organization
UMPQUA FAMILY THERAPY LLC
Active
Other names
Meredith Concepcion, LCSW, Meredith A Yost-Concepcion, Meredith Concepcion
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEREDITH ANN CONCEPCION LCSW (OWNER/PROVIDER)
(458) 802-3883
Entity
Organization
Contact information
Practice address
1299 NW ELLAN ST STE 2, ROSEBURG, OR 97470-2031
(458) 802-3883
(541) 900-1840
Mailing address
1299 NW ELLAN ST STE 2, ROSEBURG, OR 97470-2031
(458) 802-3883
(541) 900-1840
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104401439
NPPES BUSINESS NPI
OR
01
—
1265833388
NPI
OR
05
—
14105272
—
OR
01
—
L7566
LCSW LICENSE
OR
Enumeration date
03/17/2021
Last updated
08/23/2021
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