Titan Colby Marval, CRM, PSSAD

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

19-CRM-084 Issued in OR

Practice address

109 N.E. Menzanita Avenue
Grants Pass, OR 97526-1400

Phone

(541) 479-8847

Fax

(541) 471-2679

NPI assigned

Aug 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Choices Counseling

  • Health Maintenance Organization
  • Grants Pass, OR
  • NPI 1942694336
  NPD (past)
• Grants Pass Management Services, Inc.

  dba Choices

  • Addiction (Substance Use Disorder) Counselor
  • Grants Pass, OR
  • NPI 1871703702
  NPD (past)

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1922654201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N.E. MENZANITA AVENUE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261400",
            "telephone_number": "541-479-8847",
            "fax_number": "541-471-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N.E. MENZANITA AVENUE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261400",
            "telephone_number": "541-479-8847",
            "fax_number": "541-471-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVAL",
        "first_name": "TITAN",
        "middle_name": "COLBY",
        "credential": "CRM, PSSAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "19-CRM-084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "19-CRM-084",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen E Martinez, DDS
• Korbin Martinez
• Tatiana Rose Martinez, RPH,PHARMD
• Adam Dominic Martini, LAC
• Mary Martins
• Deborah Lee Marynak, D.D.S.
• James Austin Mason
• Nancy Jean Mason, APRN
• Desiree Ann Mata, PT
• Dylan Ray Mathis, DO

• Peer Specialist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.