Provider Demographics
NPI:1740646926
Name:TITANIUM COUNSELING PLLC
Entity type:Organization
Organization Name:TITANIUM COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:MUNN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:972-768-9653
Mailing Address - Street 1:675 TOWN SQUARE BLVD
Mailing Address - Street 2:SUITE 200, BLDG 1A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2992
Mailing Address - Country:US
Mailing Address - Phone:972-768-9653
Mailing Address - Fax:214-299-7601
Practice Address - Street 1:675 TOWN SQUARE BLVD
Practice Address - Street 2:SUITE 200, BLDG 1A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2992
Practice Address - Country:US
Practice Address - Phone:972-768-9653
Practice Address - Fax:214-299-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty