Provider Demographics
NPI:1235558412
Name:TITUS, KATHERINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:TITUS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:TACONIC
Mailing Address - State:CT
Mailing Address - Zip Code:06079-0133
Mailing Address - Country:US
Mailing Address - Phone:212-598-4317
Mailing Address - Fax:
Practice Address - Street 1:1 WEST ST
Practice Address - Street 2:APT 2336
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-1021
Practice Address - Country:US
Practice Address - Phone:212-598-4317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044315-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker