IndividualActive
Broderick States
NPI 1073178794 · Mental Health Counselor · Medford, OR
Broderick States is a Mental Health Counselor provider in Medford, OR (NPI 1073178794).
Provider details
- NPI number
- 1073178794
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3200 Juanipero Way
Medford, OR 97504
Phone: (541) 816-4131
Fax: (458) 226-2163
Street-level locationGet directions
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Registry dates
- Enumerated
- 2019-05-08
- Last updated
- 2019-05-08
Frequently asked questions
- What is Broderick States's NPI number?
- Broderick States's National Provider Identifier (NPI) is 1073178794, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Broderick States's specialty?
- Broderick States is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Broderick States located?
- Broderick States's practice location on file with NPPES is 3200 Juanipero Way, Medford, OR 97504.
- What is Broderick States's phone number?
- The practice phone number listed in the NPPES registry for Broderick States is (541) 816-4131.
- Is Broderick States's NPI active?
- Yes — Broderick States's NPI (1073178794) is active in the NPPES registry as of the last update on 2019-05-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.