Provider Demographics
NPI:1497181994
Name:MATTHEWS, CORIANN RANEA (MSW, CSWA)
Entity Type:Individual
Prefix:MS
First Name:CORIANN
Middle Name:RANEA
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 S CENTRAL AVE # 215E
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7851
Mailing Address - Country:US
Mailing Address - Phone:541-203-0056
Mailing Address - Fax:541-227-2356
Practice Address - Street 1:724 S CENTRAL AVE # 215E
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7851
Practice Address - Country:US
Practice Address - Phone:541-203-0056
Practice Address - Fax:541-227-2356
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500700878OtherDMAP