Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Broderick Daniel Blues Buckholz, BA

Individual provider Mental Health Counselor · NPI 1427756030

Mr. Broderick Daniel Blues Buckholz, BA is a Mental Health Counselor in Jasper, Oregon. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
BA — Bachelor of Arts
An undergraduate arts degree.

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Practice location Address checks out

37875 Jasper Lowell Rd
Jasper, OR 97438-9751
Phone: (541) 747-1235
Fax: (541) 747-4722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1427756030
Entity typeIndividual (Type 1)
GenderMale
Credentials BA
Sole proprietorYes
NPI enumeratedFebruary 22, 2023
Last updated in NPPESFebruary 22, 2023
Certification dateFebruary 22, 2023

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