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JACK DILLON BRAVO CADC-R
NPI 1063399574
Counselor in Medford, OR

Active since August 18, 2025
300 W MAIN ST, MEDFORD, OR 97501(541) 772-1777(541) 734-2410 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack Dillon Bravo Cadc-r NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK DILLON BRAVO CADC-R (NPI 1063399574) is an individual counselor in Medford, Oregon and active in the NPI registry since August 2025.

NPPES Registry Identity

NPI1063399574
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameJACK DILLON BRAVOCredential: CADC-R
Location Address300 W MAIN STMedford, OR 97501-2756
Mailing Address971 Peachwood CtMedford, OR 97501-8108 · (541) 772-1777 · Fax (541) 734-2410
Phone(541) 772-1777
Fax(541) 734-2410
Sole ProprietorNo
Enumeration DateAugust 18, 2025
NPPES CertifiedAugust 18, 2025
✔ NPI 1063399574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

300 W MAIN ST, Medford, OR 97501
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHOSHANNA NOELLE LANE
Counselor (Mental Health)
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 772-1777
MISS BRENDA PALOMERA
Counselor (Addiction (Substance Use Disorder))
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 772-1777
MONICA BOONE
Technician, Health Information
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 772-4648
JOSUE R GUERRERO CADC-R
Counselor (Addiction (Substance Use Disorder))
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 772-1777
CODY J DOLLARHIDE
Counselor (Addiction (Substance Use Disorder))
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 772-1777
SHERRI LEE LANDRENEAU CADC-R
Counselor (Addiction (Substance Use Disorder))
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (547) 772-1777
ARCHANA N SUNDAR
Counselor (Mental Health)
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 237-5059
KAYLA LUSK
Counselor (Addiction (Substance Use Disorder))
300 W MAIN ST
MEDFORD, OR 97501
Jackson County (541) 200-2414

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Bravo's NPI number?

The NPI number for Jack Bravo is 1063399574. It was assigned to this individual provider in the NPPES registry on August 18, 2025.

Where is Jack Bravo located?

Jack Bravo practices at 300 W Main St, Medford, OR 97501. The listed phone number is (541) 772-1777.

What is Jack Bravo's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Jack Bravo was last updated on August 18, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.