NPI Code Details Logo

NPI 1023951639

NPI 1023951639 : TITUS A MYERS MFT : SAINT CLAIR SHORES, MI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1023951639
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    TITUS A MYERS MFT
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/10/2026
-----------------------------------------------------
    Last Update Date     |    04/10/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    22602 DORION ST 
-----------------------------------------------------
    City                 |    SAINT CLAIR SHORES
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48082-2437
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    248-202-9582
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 80718 
-----------------------------------------------------
    City                 |    SAINT CLAIR SHORES
-----------------------------------------------------
    State                |    MI
-----------------------------------------------------
    Zip                  |    48080-5718
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    248-202-9582
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    415100217
-----------------------------------------------------
    License Number State |    MI
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.