Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIM BLACK
ActiveTIM BLACK is a Counselor healthcare provider located in EUGENE, Oregon. NPI 1104382324 is currently active in the NPPES registry. Verify at CMS.
Counselor · EUGENE, OR
Registration Details
- NPI Number
- 1104382324
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 12, 2019 (7.4971886629414 yrs)
- Last Updated
- Feb 8, 2022
- License
-
PROFESSIONALLICENSE
Practice Information
- Address
-
2222 COBURG RD STE 100EUGENE, OR, 974014988Browse OR providers · Browse ZIP 97401
- Phone
- 4582102984
- Fax
- 4582102985
- Primary Specialty
-
Counselor
101Y00000X
Other Counselor Providers in EUGENE, OR
| Name | Credential | NPI |
|---|---|---|
| JOSEPH STEINER JR. | LPA, MS | 1346270964 |
| MR. BRANDT RICHARD STUART | PA LPC | 1588770887 |
| KRISTI DURANT | — | 1528157740 |
| MR. TIMOTHY FARR PIEHLER | — | 1760558910 |
| MR. DANIEL B DUNCAN | LPC | 1659447860 |
| MRS. NIKKI RENEE EHRMANTROUT | MS QMHP | 1619043833 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.