MEDICARE: MARIUS HAYNES MA

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	101YM0800X	Mental Health Counselor	LPC015981	GA

General Provider Information

NPI Number	:	1770299299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIUS HAYNES MA

Provider Business Mailing Address
First Line	:	1445 WOODMONT LN NW # 1576
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-2866
Country	:	US
Telephone Number	:	678-439-9804
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 TWIN HILL RD
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-7724
Country	:	US
Telephone Number	:	678-439-9804
Fax Number	:

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

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	10/06/2025

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Directions to “ MARIUS HAYNES MA” Practice Location

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