Active NPI
Madx Omni Bedard, MSW, QMHP-R
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1811405707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 6902 SE Lake Rd
Portland, OR 97267-2148 - Phone
- (503) 358-7884
- NPI assigned
- Jan 13, 2018
- Reactivated
- Aug 11, 2025
- Last updated
- Oct 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
6902 SE Lake Rd
Portland, OR 97267-2148
Mailing address
6200 SE King Rd
Portland, OR 97222-2891
Phone (503) 358-7884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Family Services | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Portland, OR
- NPI 1275695934
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759449600000",
"number": "1811405707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 SE KING RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972222891",
"telephone_number": "503-358-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6902 SE LAKE RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972672148",
"telephone_number": "503-358-7884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDARD",
"first_name": "MADX",
"middle_name": "OMNI",
"credential": "MSW, QMHP-R",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-13",
"last_updated": "2025-10-03",
"certification_date": "2025-10-03",
"deactivation_date": "2022-01-24",
"reactivation_date": "2025-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.