Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Josandra Defazio, LGSW

Individual provider Clinical Social Worker · NPI 1609598671

Josandra Defazio, LGSW is a Clinical Social Worker in Bridgeport, West Virginia. Qualified in 2022, 4 years ago. Licensed in West Virginia.

Years since qualifying
4
Licensed in
WV
In the registry since
2022
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Practice location Address checks out

65 Professional Pl Ste 102
Bridgeport, WV 26330-0259
Phone: (304) 848-5770
Fax: (304) 848-5477
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence DP00946344 (WV)

Record details

NPI number1609598671
Entity typeIndividual (Type 1)
GenderFemale
Credentials LGSW
Sole proprietorNo
NPI enumeratedSeptember 15, 2022
Last updated in NPPESDecember 9, 2025
Certification dateDecember 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Bridgeport