Stacey Titus, L.M.S.W

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW - 35801 Issued in ID

Practice address

11868 W Gunsmoke Dr
Boise, ID 83713-4753

Phone

(208) 860-2656

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Northwest Neurobehavioral Health PLLC

  • Clinical Psychologist
  • Boise, ID
  • NPI 1518102797
  NPD (past)

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1801244843",
    "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": "11868 W GUNSMOKE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837134753",
            "telephone_number": "208-860-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITUS",
        "first_name": "STACEY",
        "credential": "L.M.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW - 35801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Lynn Tipton, PT, DPT
• Taylor Ann Tipton, DNP, FNP-C
• Laura L Tirrell, MD
• Sarah Kimberly Tish, LMSW
• Catherine Tisler
• Anja Tjaden, MD
• TLC Home Health Care & Nursing Inc.
• TMD PLLC
• Christopher Emil Tobe, M.D.
• Sophie Tobeck, CNM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.