Provider Demographics
NPI:1376014787
Name:TITZE, ERIN (LCSW, MED)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:TITZE
Suffix:
Gender:F
Credentials:LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E PHIL ELLENA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1944
Mailing Address - Country:US
Mailing Address - Phone:610-910-8886
Mailing Address - Fax:
Practice Address - Street 1:3819 GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-3164
Practice Address - Country:US
Practice Address - Phone:610-910-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0188131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical