Provider Demographics
NPI:1043388945
Name:TITUS-SMITH, SARAH B (LICSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:TITUS-SMITH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1689
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-1689
Mailing Address - Country:US
Mailing Address - Phone:603-969-0273
Mailing Address - Fax:
Practice Address - Street 1:56 FURBER LANE, PO BOX 1689
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-1689
Practice Address - Country:US
Practice Address - Phone:603-969-0273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH7706655Y0NH01OtherBHN
NH99003227Medicaid
NHNH3227Medicare ID - Type Unspecified