MEDICARE: CHRISTOPHER JEAN-GILLES 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
1	1041C0700X	Clinical Social Worker	106921	TX

General Provider Information

NPI Number	:	1801655527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JEAN-GILLES LCSW

Provider Business Mailing Address
First Line	:	395 SAWDUST RD # 3124
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2242
Country	:	US
Telephone Number	:	409-205-6034
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 SAWDUST RD # 3124
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-2242
Country	:	US
Telephone Number	:	409-205-6034
Fax Number	:

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

Provider Enumeration Date	:	03/15/2024
Last Update Date	:	01/02/2025

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