Provider Demographics
NPI:1235867680
Name:TIMBERLINE COUNSELING LLC
Entity Type:Organization
Organization Name:TIMBERLINE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, DBH, BCD
Authorized Official - Phone:541-842-0907
Mailing Address - Street 1:1394 KUBLI RD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-8632
Mailing Address - Country:US
Mailing Address - Phone:541-842-0907
Mailing Address - Fax:
Practice Address - Street 1:1394 KUBLI RD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-8632
Practice Address - Country:US
Practice Address - Phone:541-842-0907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty