Provider Demographics
NPI:1689707044
Name:GUIDING STAR PSYCHIATRIC SERVICES, P.C.
Entity Type:Organization
Organization Name:GUIDING STAR PSYCHIATRIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-861-8836
Mailing Address - Street 1:1 TAMZEN TER
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-2484
Mailing Address - Country:US
Mailing Address - Phone:610-861-8836
Mailing Address - Fax:
Practice Address - Street 1:901 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1974
Practice Address - Country:US
Practice Address - Phone:610-861-8836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H92130Medicare UPIN
NJ072418Medicare ID - Type Unspecified
PA077011Medicare ID - Type Unspecified