Active NPIIndividual provider

Tim Black

Counselor in Eugene, Oregon

NPI Number1104382324
Practice location
2222 Coburg RD Ste 100, Eugene, OR 97401-4988
Fax
458-210-2985
Last updated
February 8, 2022

Tim Black is a Counselor based in Eugene, OR. Tim Black practices in Eugene, OR. The NPI Number for Tim Black is 1104382324 and holds a License No. professionallicense. The current practice location address for Tim Black is 2222 Coburg RD Ste 100, Eugene, OR 97401-4988 and can be reached out via phone at 458-210-2984 and via fax at 458-210-2985.

Provider Profile Details

NPI Number
1104382324
Provider Name
Tim Black
Provider Entity Type
Individual
Gender
Male
Address
2222 Coburg RD Ste 100, Eugene, OR 97401-4988
Phone Number
458-210-2984
Fax Number
458-210-2985
Primary Taxonomy
Counselor · 101Y00000X
Sole Proprietor
No
Provider Enumeration Date
February 12, 2019
Last Update Date
February 8, 2022
NPI Status
Active

Provider Business Practice Location Address Details

Address
2222 Coburg RD Ste 100
Eugene, OR 97401-4988
City
Eugene
State
Oregon
Zip
97401-4988
Phone Number
458-210-2984
Fax Number
458-210-2985
Eugene, OR 97401Get directions →

Provider Business Mailing Address Details

Address
3587 Heathrow Way
Medford, OR 97504-4004
City
Medford
State
OR
Zip
97504-4004
Phone Number
541-858-8170

License Information

License Number
professionallicense
Taxonomy
Counselor · 101Y00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

Other Counselors near Eugene, OR

View all Counselors in Eugene →

Frequently Asked Questions

What is the NPI number of Tim Black?

The NPI number of Tim Black is 1104382324. It was assigned on February 12, 2019 and is currently active in the NPPES registry.

What is the specialty of Tim Black?

Tim Black is registered under the primary taxonomy Counselor (code 101Y00000X), licensed under license number professionallicense.

Where does Tim Black practice?

The practice location is 2222 Coburg RD Ste 100, Eugene, OR 97401-4988. The office can be reached at 458-210-2984 (phone) or 458-210-2985 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1104382324 directly on the NPPES registry website.

Browse related providers