Provider Demographics
NPI:1568269173
Name:PAGE, TITAN (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:TITAN
Middle Name:
Last Name:PAGE
Suffix:
Gender:
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 CATTLE BARON PATH UNIT 204
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-4212
Mailing Address - Country:US
Mailing Address - Phone:972-567-6440
Mailing Address - Fax:972-567-6440
Practice Address - Street 1:9015 CATTLE BARON PATH UNIT 204
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-4212
Practice Address - Country:US
Practice Address - Phone:972-567-6440
Practice Address - Fax:972-567-6440
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96887101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional