Provider Demographics
NPI:1578090049
Name:TITUS, BARBARA (LADC CSAC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:TITUS
Suffix:
Gender:F
Credentials:LADC CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-2595
Mailing Address - Country:US
Mailing Address - Phone:715-392-9300
Mailing Address - Fax:715-392-8041
Practice Address - Street 1:1810 BELKNAP ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-2595
Practice Address - Country:US
Practice Address - Phone:715-392-9300
Practice Address - Fax:715-392-8041
Is Sole Proprietor?:No
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304322101YA0400X
WI16108-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)