Provider Demographics
NPI:1699782383
Name:TITUS, LINDA B (LMFT NCACII)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:B
Last Name:TITUS
Suffix:
Gender:F
Credentials:LMFT NCACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SHOPPERS WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0522
Mailing Address - Country:US
Mailing Address - Phone:912-265-7660
Mailing Address - Fax:912-265-7858
Practice Address - Street 1:106 SHOPPERS WAY STE 115
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-0522
Practice Address - Country:US
Practice Address - Phone:912-265-7660
Practice Address - Fax:912-265-7858
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA602101YA0400X
NAADAC12341101YA0400X
GA720103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11511760OtherCAQH