Healthcare Provider Details

I. General information

NPI: 1073625554
Provider Name (Legal Business Name): JOSEPHINE COUNTY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 SW G ST
GRANTS PASS OR
97526-2544
US

IV. Provider business mailing address

1215 SW G ST
GRANTS PASS OR
97526-2544
US

V. Phone/Fax

Practice location:
  • Phone: 541-476-2373
  • Fax: 541-476-1526
Mailing address:
  • Phone: 541-476-2373
  • Fax: 541-476-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. COLEEN A. MAGORIAN
Title or Position: ACCOUNTING TECHNICIAN
Credential:
Phone: 541-476-2373