Provider Demographics
NPI:1942782933
Name:GILES, DEVIN MICHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:DEVIN
Middle Name:MICHAEL
Last Name:GILES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:D. MICHAEL
Other - Middle Name:
Other - Last Name:GILES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7303 WOOD HOLLOW DR APT 204
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-2538
Mailing Address - Country:US
Mailing Address - Phone:512-241-8135
Mailing Address - Fax:
Practice Address - Street 1:2906 SAN GABRIEL ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3533
Practice Address - Country:US
Practice Address - Phone:737-241-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical