Active NPI
Joseph C Titus, LCSW-C
- Clinical Social Worker
- Centreville, MD
National Provider Identifier
1730129370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17325
- Practice address
- 120 Banjo Lane
Centreville, MD 21617 - Phone
- (410) 758-2211
- Fax
- (410) 758-0698
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17325 | MD | Primary |
| Clinical Social Worker | 1041C0700X | G12151 | MD |
Addresses
Primary practice location
120 Banjo Lane
Centreville, MD 21617
Mailing address
120 Banjo Lane
Centreville, MD 21617
Phone (410) 758-2211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 774800100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G12151 | MD | MD | Clinical Social Worker |
| 17325 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corsica River Mental Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Centreville, MD
- NPI 1396077749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510704000000",
"number": "1730129370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 BANJO LANE",
"city": "CENTREVILLE",
"state": "MD",
"postal_code": "21617",
"telephone_number": "410-758-2211",
"fax_number": "410-758-0698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 BANJO LANE",
"city": "CENTREVILLE",
"state": "MD",
"postal_code": "21617",
"telephone_number": "410-758-2211",
"fax_number": "410-758-0698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITUS",
"first_name": "JOSEPH",
"middle_name": "C",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2017-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "17325",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "G12151",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "774800100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Centreville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.