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NPI Code Detail

MEDICARE: JALISA GILES LCSW

MEDICARE: JALISA GILES LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker64874TX
21041C0700XClinical Social Worker6911SD
31041C0700XClinical Social Worker236593AK
41041C0700XClinical Social Worker34562MN
51041C0700XClinical Social Worker81414MT
61041C0700XClinical Social Worker9860TN
71041C0700XClinical Social Worker6932ND

General Provider Information

NPI Number : 1043990468
Entity Type Code : Individual
Provider Name (Legal Business Name) : JALISA GILES LCSW
Provider Business Mailing Address
First Line : 701 TILLERY ST STE 12
Second Line :
City : AUSTIN
State : TX
Zip : 78702-3751
Country : US
Telephone Number : 512-270-9622
Fax Number :
Provider Business Practice Location Address
First Line : 3674 S WASHINGTON ST
Second Line :
City : GRAND FORKS
State : ND
Zip : 58201-5766
Country : US
Telephone Number : 701-205-3000
Fax Number : 701-732-2501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2023
Last Update Date : 04/10/2026

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Directions to “ JALISA GILES LCSW” Practice Location

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