Jacqueline Mezza Titus, PH.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

6301013657 Issued in MI

Practice address

151 Psychology BLDG
Michigan State Psychological Clinic
East Lansing, MI 48824-1116

Phone

(517) 599-4934

NPI assigned

Aug 14, 2008

Last updated

Oct 7, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psychological Services of East Lansing, PLLC

  • Clinical Psychologist
  • East Lansing, MI
  • NPI 1083984405
  Authorized official Same address or phone

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1790931251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 PSYCHOLOGY BUILDING",
            "address_2": "MSU PSYCHOLOGICAL CLINIC",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48824",
            "telephone_number": "517-599-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 PSYCHOLOGY BLDG",
            "address_2": "MICHIGAN STATE PSYCHOLOGICAL CLINIC",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241116",
            "telephone_number": "517-599-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITUS",
        "first_name": "JACQUELINE",
        "middle_name": "MEZZA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014282",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "6301013657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Rose Tilley
• Sara Elizabeth Timmons, PH.D., LMFT
• Sacelia Marie Tirrell
• Stefan Titianu
• Christopher E Title, FNP-BC
• Morgan Titus
• Tmcm4 LLC
• Julie Tobin
• Todd Westfall LPC PLLC
• Hannah Christine Tokish, MA

• Student in an Organized Health Care Education/Training Program in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.