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STACEY TITUS PLLC

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Company Details

Name: STACEY TITUS PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 24 May 2016 (9 years ago)
Financial Date End: 31 May 2026
Entity Number: 506576
Place of Formation: IDAHO
File Number: 506576
ZIP code: 83713
County: Ada County
Principal Address: 11868 W GUNSMOKE DR BOISE, ID 83713
Mailing Address: 11868 W GUNSMOKE DR BOISE, ID 83713-4753

Agent

Name Role Address
STACEY TITUS Agent 11868 W GUNSMOKE DR, BOISE, ID 83713

Manager

Name Role Address Appointed On
Stacey Titus Manager 11868 W. GUNSMOKE DR., BOISE, ID 83713 2021-05-05

National Provider Identifier

NPI Number:
1417577412
Certification Date:
2020-04-20

Authorized Person:

Name:
MRS. STACEY TITUS
Role:
LICENSED CLINICAL SOCIAL WORKER
Phone:

Taxonomy:

Selected Taxonomy:
1041C0700X - Clinical Social Worker
Is Primary:
Yes

Contacts:

Filing

Filing Name Filing Number Filing date
Annual Report 0006201180 2025-04-08
Annual Report 0005725537 2024-05-06
Annual Report 0005233323 2023-05-08
Annual Report 0004755154 2022-05-23
Annual Report 0004275532 2021-05-05

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Date of last update: 02 Jul 2025

Sources: Idaho Secretary of State