Provider Demographics
NPI:1265515092
Name:TITONE, ANITA M (LCSW, LMFT)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:TITONE
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 CHARLESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1706
Mailing Address - Country:US
Mailing Address - Phone:972-726-7254
Mailing Address - Fax:972-726-7254
Practice Address - Street 1:5916 CHARLESTOWN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1706
Practice Address - Country:US
Practice Address - Phone:972-726-7254
Practice Address - Fax:972-726-7254
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001247OtherLMFT
TX00663PMedicare ID - Type Unspecified