Healthcare Provider Details

I. General information

NPI: 1497240444
Provider Name (Legal Business Name): TIM BUEHLER LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 SKYLINE DR STE 200
MARION IL
62959-4874
US

IV. Provider business mailing address

812 SKYLINE DR STE 200
MARION IL
62959-4874
US

V. Phone/Fax

Practice location:
  • Phone: 618-440-1534
  • Fax:
Mailing address:
  • Phone: 618-440-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180013903
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: