MEDICARE: MARIANNA ELISABETH HILES APC

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	APC010788	GA

General Provider Information

NPI Number	:	1780548982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNA ELISABETH HILES APC

Provider Business Mailing Address
First Line	:	3720 CHAMBLEE DUNWOODY RD STE D2
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2064
Country	:	US
Telephone Number	:	678-802-9355
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 CHAMBLEE DUNWOODY RD STE D2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30341-2064
Country	:	US
Telephone Number	:	678-802-9355
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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