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NPI 1730129370

NPI 1730129370 : JOSEPH C TITUS LCSW-C : CENTREVILLE, MD

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General NPI Number Information
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    NPI Number           |    1730129370
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH C TITUS LCSW-C
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/08/2006
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    Last Update Date     |    11/15/2017
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Provider Practice Location Address
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    Address Line         |    120 BANJO LANE 
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    City                 |    CENTREVILLE
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    State                |    MD
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    Zip                  |    21617
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    Country              |    US
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    Telephone            |    410-758-2211
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    Fax                  |    410-758-0698
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Provider Business Mailing Address
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    Address Line         |    120 BANJO LANE 
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    City                 |    CENTREVILLE
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    State                |    MD
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    Zip                  |    21617
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    Country              |    US
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    Telephone            |    410-758-2211
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    Fax                  |    410-758-0698
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    17325
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    G12151
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    License Number State |    MD
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