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MR. BRODERICK DANIEL BLUES BUCKHOLZ BA
NPI 1427756030
Counselor - Mental Health in Jasper, OR

Active since February 22, 2023
37875 JASPER LOWELL RD, JASPER, OR 97438(541) 747-1235(541) 747-4722 Get Directions Write a Review

NPPES record last updated: February 22, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Broderick Daniel Blues Buckholz Ba NPPES

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

MR. BRODERICK DANIEL BLUES BUCKHOLZ BA (NPI 1427756030) is an individual mental health provider in Jasper, Oregon and active in the NPI registry since February 2023.

NPPES Registry Identity

NPI1427756030
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. BRODERICK DANIEL BLUES BUCKHOLZCredential: BA
Location Address37875 JASPER LOWELL RDJasper, OR 97438-9751
Mailing Address2620 Potter StEugene, OR 97405-4124 · (503) 383-2481
Phone(541) 747-1235
Fax(541) 747-4722
Sole ProprietorYes
Enumeration DateFebruary 22, 2023
NPPES CertifiedFebruary 22, 2023
✔ NPI 1427756030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
37875 JASPER LOWELL RD, Jasper, OR 97438
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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.

MRS. JULIE ENGEL B.A., QMHA
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
SARA JANE BELLAMY BS
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
TORIANA MAHAFFIE
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
KATRINA S WELCH
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
MS. TREVECCA WINTERS AAOT
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
MRS. JOYCE ZIEGLER B.A., QMHA
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
KATELYNN SALLEE
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235
MIKA MAII
Counselor (Mental Health)
37875 JASPER LOWELL RD
JASPER, OR 97438
Lane County (541) 747-1235

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 Broderick Buckholz's NPI number?

The NPI number for Broderick Buckholz is 1427756030. It was assigned to this individual provider in the NPPES registry on February 22, 2023.

Where is Broderick Buckholz located?

Broderick Buckholz practices at 37875 Jasper Lowell Rd, Jasper, OR 97438. The listed phone number is (541) 747-1235.

What is Broderick Buckholz's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Broderick Buckholz was last updated on February 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.