NPIMap

Organization Active NPI

Family Behavioral Health Network, LLC

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1538708953
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FAMILY BEHAVIORAL HEALTH NETWORK, LLC
Practice address
221 W Main St
Medford, OR 97501-2728
Phone
(541) 821-9559
Fax
(541) 702-1236
NPI assigned
Jan 2, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HENDERSON BEHAVIORAL HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jennifer May Henderson, DBHNPI 1962675249
Title
President
Phone
(541) 821-9559

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

221 W Main St
Medford, OR 97501-2728

Mailing address

PO Box 8097
Medford, OR 97501-0997
Phone (541) 821-9559

Other identifiers 1

IdentifierTypeStateIssuer
500653416MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jennifer@jhendersoncounseling.com Direct Henderson Behavioral Health, LLC

National Provider Directory

National Provider Directory
Part of
Henderson Behavioral Health LLC

Locations

221 W Main St
Medford, OR 97501
Phone (541) 821-9559

Interoperability endpoints

  • Direct secure messaging: jennifer@jhendersoncounseling.com

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1538708953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8097",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010997",
            "telephone_number": "541-821-9559",
            "fax_number": "541-702-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975012728",
            "telephone_number": "541-821-9559",
            "fax_number": "541-702-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY BEHAVIORAL HEALTH NETWORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENDERSON BEHAVIORAL HEALTH, LLC",
        "enumeration_date": "2020-01-02",
        "last_updated": "2023-11-27",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-821-9559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DBH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500653416",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer@jhendersoncounseling.com",
            "affiliation": "Y",
            "endpointDescription": "Secure EMAIL",
            "affiliationName": "Henderson Behavioral Health, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "221 W Main St",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975012728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.