TITAN COLBY MARVAL CRM PSSAD NPI 1922654201

NPI Information

NPI: 1922654201
Provider Name: TITAN COLBY MARVAL, CRM, PSSAD
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
109 N.E. MENZANITA AVENUE
GRANTS PASS, OR
ZIP 97526
Phone: (541) 479-8847
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Titan Colby Marval, CRM, PSSAD is a peer specialist in Grants Pass, OR. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Titan Colby Marval, CRM, PSSAD NPI is 1922654201. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

109 N.E. MENZANITA AVENUE
GRANTS PASS, OR
ZIP 97526-400
Phone: (541) 479-8847
Fax: (541) 471-2679

The enumeration date for this NPI number is 8/13/2019 and was last updated on 8/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist		19-CRM-084	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	19-CRM-084	OTHER	OREGON	MHACBO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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