Provider Demographics
NPI:1851853857
Name:TITUS, KIMBERLY LOUISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:TITUS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LOUISE
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3104 SCENIC CT
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-3482
Mailing Address - Country:US
Mailing Address - Phone:914-557-3817
Mailing Address - Fax:
Practice Address - Street 1:435 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6422
Practice Address - Country:US
Practice Address - Phone:973-971-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00608000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical