Provider Demographics
NPI:1497912166
Name:JOSEPH C TITONE LLC
Entity Type:Organization
Organization Name:JOSEPH C TITONE LLC
Other - Org Name:FAMILY CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:TITONE
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:609-880-0388
Mailing Address - Street 1:4 CANDLELIGHT DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-2237
Mailing Address - Country:US
Mailing Address - Phone:609-880-0388
Mailing Address - Fax:609-880-1348
Practice Address - Street 1:4 CANDLELIGHT DR
Practice Address - Street 2:
Practice Address - City:EDGEWATER PARK
Practice Address - State:NJ
Practice Address - Zip Code:08010-2237
Practice Address - Country:US
Practice Address - Phone:609-880-0388
Practice Address - Fax:609-880-1348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023337Medicaid