Individual
MEREDITH ANN CONCEPCION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
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
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
36490
CA
104100000X
Social Worker
L7566
OR
1041C0700X
Clinical Social Worker
Primary
L7566
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500740754
—
OR
01
—
86-2721279
GROUP PRACTICE TAX ID
OR
Enumeration date
09/08/2014
Last updated
05/13/2023
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