Individual provider · Type 1 NPI

Tim Black

Counselor · Eugene, OR

NPI number 1104382324 Active

Practice location

2222 Coburg Rd Ste 100
Eugene, OR 97401-4988

Call (458) 210-2984 Map

Fax (458) 210-2985

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XPROFESSIONALLICENSE

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1104382324

Tim Black's National Provider Identifier is 1104382324, issued on Feb 12, 2019. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Eugene, OR. The record was last updated on Feb 8, 2022.