Provider Demographics
NPI:1427501501
Name:CONGDON, JOSIE DION (MSW, QMHP, CSWA)
Entity type:Individual
Prefix:MRS
First Name:JOSIE
Middle Name:DION
Last Name:CONGDON
Suffix:
Gender:F
Credentials:MSW, QMHP, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1121
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-0254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3099 NE DIAMOND LAKE BLVD
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3655
Practice Address - Country:US
Practice Address - Phone:541-673-3469
Practice Address - Fax:541-672-8072
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical