Healthcare Provider Details

I. General information

NPI: 1316925936
Provider Name (Legal Business Name): PHYLLIS JEAN JOSSY M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAHC CMR 457, BOX 323
APO AE
09033
DE

IV. Provider business mailing address

USAHC CMR 457, BOX 323
APO AE
09033
DE

V. Phone/Fax

Practice location:
  • Phone: 09721966510
  • Fax: 09721966520
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00590
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: