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General NPI Number Information
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NPI Number | 1619652617
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Entity Type | Individual
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Provider Name | BRIAN JAMES TITUS LLPC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 3300 WASHTENAW AVE STE 222
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City | ANN ARBOR
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State | MI
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Zip | 48104-4261
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Country | US
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Telephone | 734-203-0183
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Fax |
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Provider Business Mailing Address
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Address Line | 42933 LOMBARDY DR
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City | CANTON
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State | MI
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Zip | 48187-2320
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Country | US
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Telephone | 734-612-5269
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6451023054
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License Number State | MI
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