MEDICARE: MRS. TANEIA LATRICE GILES M.ED., M.A., L.P.C

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
1	101Y00000X	Counselor	6401013775	MI
2	101YP2500X	Professional Counselor	6401225986	MI

General Provider Information

NPI Number	:	1164948956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANEIA LATRICE GILES M.ED., M.A., L.P.C

Provider Business Mailing Address
First Line	:	39249 PLUMBROOK DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-2915
Country	:	US
Telephone Number	:	248-506-0671
Fax Number	:

Provider Business Practice Location Address
First Line	:	29532 SOUTHFIELD RD STE 208
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	248-590-6968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	04/15/2026

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