Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104382324 Individual Practitioner Male Practitioner

Tim Black

Counselor • Eugene, OR

Professional Overview & Biography Verified Profile Summary

Tim Black is a registered healthcare professional specializing in Counselor in Eugene, OR. Practice services are available at 2222 COBURG RD STE 100 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2222 Coburg Rd Ste 100

Eugene, OR 974014988

Telephone 4582102984
Fax 4582102985
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Eugene, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
534 Specialists

Practicing in Eugene, OR (4551 Statewide)

Telehealth Adoption Rate
0.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License None PROFESSIONALLICENSE

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Ashlynn Barwig

Behavior Technician

NPI 1013601673
Crystal Johnston

Registered Nurse - Psychiatric/Mental Health

NPI 1033428636
Jennifer Graham

Counselor - Mental Health

NPI 1033578265
Kardo Valencia

Counselor - Mental Health

NPI 1043963879
Cameron Hansen

Counselor - Mental Health

NPI 1053835587
Justin Jennings

Counselor - Mental Health

NPI 1073057949

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location February 08, 2022

Registered at 2222 COBURG RD STE 100, EUGENE, OR 974014988 (Tel: 4582102984)

📍
Updated Business Mailing Address February 08, 2022

Registered at 3587 HEATHROW WAY, MEDFORD, OR 975044004 (Tel: 5418588170)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2022

Counselor (License #PROFESSIONALLICENSE in None)

NPI Profile Active February 12, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location February 12, 2019

Registered at 341 E 12TH AVE, EUGENE, OR 974013275 (Tel: 5413428255)

📍
Updated Business Mailing Address February 12, 2019

Registered at 341 E 12TH AVE, EUGENE, OR 974013275 (Tel: 5413428255)

👤
Provider Name / Credentials Updated February 12, 2019

Recorded as TIM BLACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 12, 2019

Counselor

🟢
Initial NPI Registration & Enumeration February 12, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104382324
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 12, 2019
Last Update: February 08, 2022
Sole Proprietor: No

Mailing Address

3587 Heathrow Way

Medford, OR 975044004

Phone: 5418588170

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.