Individual
TITUS SHANE MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, MA
Contact information
Practice address
1905 STADIUM BLVD, JEFFERSON CITY, MO 65109
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
118627
IA
Other
Enumeration date
07/30/2018
Last updated
10/28/2025
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