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TIM BLACK
NPI 1104382324
Counselor in Eugene, OR

Active since February 12, 2019
2222 COBURG RD STE 100, EUGENE, OR 97401(458) 210-2984(458) 210-2985 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 8, 2022, Feb 12, 2019 (2 updates tracked since 2019).

About Tim Black NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIM BLACK (NPI 1104382324) is an individual counselor in Eugene, Oregon, licensed in (PROFESSIONALLICENSE) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1104382324
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameTIM BLACK
Location Address2222 COBURG RD STE 100Eugene, OR 97401-4988
Mailing Address3587 Heathrow WayMedford, OR 97504-4004 · (541) 858-8170
Phone(458) 210-2984
Fax(458) 210-2985
Sole ProprietorNo
Enumeration DateFebruary 12, 2019
Last NPPES UpdateFebruary 8, 20222 updates tracked since enumeration
✔ NPI 1104382324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed · PROFESSIONALLICENSE
Definition
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.
2222 COBURG RD STE 100, Eugene, OR 97401
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLYNN BARWIG
Behavior Technician
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
CRYSTAL JOHNSTON
Registered Nurse (Psychiatric/Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
JENNIFER GRAHAM
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
KARDO JIMEMEZ VALENCIA
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
JUSTIN JENNINGS
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
ANDREA MARCOTTE
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
BETHANY DARNELL
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984
SARAH LILLIE SVENDSEN
Counselor (Mental Health)
2222 COBURG RD STE 100
EUGENE, OR 97401
Lane County (458) 210-2984

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tim Black's NPI number?

The NPI number for Tim Black is 1104382324. It was assigned to this individual provider in the NPPES registry on February 12, 2019.

Where is Tim Black located?

Tim Black practices at 2222 Coburg Rd Ste 100, Eugene, OR 97401. The listed phone number is (458) 210-2984.

What is Tim Black's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Tim Black was last updated on February 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.