- Practice location
- 2222 Coburg RD Ste 100, Eugene, OR 97401-4988
- Phone
- 458-210-2984
- Fax
- 458-210-2985
- Last updated
- February 8, 2022
Tim Black is a Counselor based in Eugene, OR. The NPI number for Tim Black is 1104382324 and holds license No. professionallicense. The current practice location address is 2222 Coburg RD Ste 100, Eugene, OR 97401-4988 and the office can be reached by phone at 458-210-2984 and by fax at 458-210-2985. The NPI was assigned on February 12, 2019 and the record was last updated in NPPES on February 8, 2022.
●Provider Profile Details
- NPI Number
- 1104382324
- Provider Name
- Tim Black
- Entity Type
- Individual (Type 1 NPI)
- Gender
- Male
- Primary Taxonomy
- Counselor · 101Y00000X
- Sole Proprietor
- No
- Enumeration Date
- February 12, 2019
- Last Update Date
- February 8, 2022
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 2222 Coburg RD Ste 100
Eugene, OR 97401-4988 - City
- Eugene
- State
- Oregon
- ZIP
- 97401-4988
- Country
- US
- Phone Number
- 458-210-2984
- Fax Number
- 458-210-2985
✉Business Mailing Address
- Address
- 3587 Heathrow Way
Medford, OR 97504-4004 - City
- Medford
- State
- OR
- ZIP
- 97504-4004
- Phone Number
- 541-858-8170
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes | professionallicense | — |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers 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) and holds license No. 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 at npiregistry.cms.hhs.gov.