MEDICARE: CURTIS 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
1	1041C0700X	Clinical Social Worker	5486876-3501	UT

General Provider Information

NPI Number	:	1942657101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS GILES LCSW

Provider Business Mailing Address
First Line	:	1531 E 575 N
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84040-3636
Country	:	US
Telephone Number	:	801-425-4303
Fax Number	:

Provider Business Practice Location Address
First Line	:	2363 N HILL FIELD RD
Second Line	:
City	:	LAYTON
State	:	UT
Zip	:	84041-6909
Country	:	US
Telephone Number	:	801-525-4645
Fax Number	:

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

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/04/2022

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