Provider Demographics
NPI:1750799235
Name:GILJE, KARI (LSW)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:GILJE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 MAIN ST S
Mailing Address - Street 2:SUITE #7
Mailing Address - City:FORMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58032-4149
Mailing Address - Country:US
Mailing Address - Phone:701-724-6241
Mailing Address - Fax:701-724-3323
Practice Address - Street 1:355 MAIN ST S
Practice Address - Street 2:SUITE #7
Practice Address - City:FORMAN
Practice Address - State:ND
Practice Address - Zip Code:58032-4149
Practice Address - Country:US
Practice Address - Phone:701-724-6241
Practice Address - Fax:701-724-3323
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4858104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker