Meredith Ann Concepcion, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7566 Issued in OR

Practice address

1299 NW Ellan St Ste 2
Roseburg, OR 97470-2031

Phone

(458) 802-3883

Fax

(541) 900-1840

NPI assigned

Sep 8, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meredith.concepcion.1@26492.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/26492/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Umpqua Family Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roseburg, OR
  • NPI 1104401439

  OR

  Medicare reassignment NPD Authorized official
• Cow Creek Band of Umpqua Tribe of Indians

  • Federally Qualified Health Center (FQHC)
  • Canyonville, OR
  • NPI 1134567993
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1265833388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 NW ELLAN ST STE 2",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702031",
            "telephone_number": "458-802-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 NW ELLAN ST STE 2",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702031",
            "telephone_number": "458-802-3883",
            "fax_number": "541-900-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "MEREDITH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "L7566",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "36490",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500740754",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE TAX ID",
            "identifier": "86-2721279",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Cancer Foundation
• Community Cancer Foundation
• Community Cancer Foundation
• Community Health Alliance
• Community Health Alliance
• Josie Dion Congdon, MSW, QMHP, CSWA
• Kelly Renee Conklin, DNP
• Tina Marie Conklin
• Leslie Conlee, BS
• Julie Connors

• All providers in Roseburg, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.