Stacey Titus PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

STACEY TITUS PLLC

Practice address

5440 W Franklin Rd Ste 201
Boise, ID 83705-6434

Phone

(208) 860-2656

NPI assigned

Apr 20, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Stacey Titus, LCSW38145

Title

Licensed Clinical Social Worker

Phone

(208) 860-2656

Specialties & licenses 1

Addresses

Other names 1

• Clearwater Counseling Services Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan Looze, LPC

  • Mental Health Counselor
  • Boise, ID
  • NPI 1366874224
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1417577412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11868 W GUNSMOKE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837134753",
            "telephone_number": "208-860-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 W FRANKLIN RD STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837056434",
            "telephone_number": "208-860-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY TITUS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "TITUS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "208-860-2656",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW38145"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clearwater Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• St. Luke'S Regional Medical Center
• St. Lukes
• Stability Mental Health, PLLC
• Debra Jean Stace, LMSW
• Julie Lynn Stace, CSFA
• Eric Gerand Stackle, MD
• Mary J Stackle, NP
• Daniel John Stackowicz, DDS
• Stacy J. Moon DDS, PA
• Mardi Stacy, PH.D.

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.