Provider Demographics
NPI:1497181994
Name:MATTHEWS, CORIANN RANEA (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:CORIANN
Middle Name:RANEA
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:MSW, LCSW
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 631
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0043
Mailing Address - Country:US
Mailing Address - Phone:541-203-0056
Mailing Address - Fax:541-227-2356
Practice Address - Street 1:713 S RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7837
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:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL10456101YM0800X, 1041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500700878OtherDMAP