Individual provider Active NPI

Jaimie Broadhead

  • Professional Counselor
  • Eugene, OR
National Provider Identifier
1912322496
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C10042 Issued in OR
Practice address
261 E 12TH Ave # 200
Eugene, OR 97401-3208
Phone
(541) 900-4285
NPI assigned
Feb 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X C10042 OR Primary

Addresses

Primary practice location

261 E 12TH Ave # 200
Eugene, OR 97401-3208

Mailing address

261 E 12TH Ave # 200
Eugene, OR 97401-3208
Phone (541) 900-4285

Other names 1

  • Jaimie Bemisdarfer Former name

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

State licenses

LicenseStateTypeSpecialty
C10042ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Development, Inc. Addiction (Substance Use Disorder) PastSince Oct 1, 2022 Accepting new patients
Center for Family Development, Inc. Addiction (Substance Use Disorder) PastSince Oct 30, 2022 Accepting new patients
Oslc Community Programs Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/c-f-d/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1912322496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 E 12TH AVE # 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013208",
            "telephone_number": "541-900-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 E 12TH AVE # 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013208",
            "telephone_number": "541-900-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHEAD",
        "first_name": "JAIMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C10042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIMIE",
            "last_name": "BEMISDARFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.