Provider Demographics
NPI:1427488030
Name:GILES, MALLORY HANSEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MALLORY
Middle Name:HANSEN
Last Name:GILES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MALLORY
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LGSW
Mailing Address - Street 1:1318 N CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-4004
Mailing Address - Country:US
Mailing Address - Phone:251-279-1119
Mailing Address - Fax:251-279-1117
Practice Address - Street 1:1601 CONCORD PIKE STE 54
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3630
Practice Address - Country:US
Practice Address - Phone:302-281-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00015951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical