Provider Demographics
NPI:1942715974
Name:HILES, JAIME LEIGH (LCDC III)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:LEIGH
Last Name:HILES
Suffix:
Gender:F
Credentials:LCDC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8978 UNITED LN STE 102
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-3668
Mailing Address - Country:US
Mailing Address - Phone:740-274-4246
Mailing Address - Fax:740-249-4944
Practice Address - Street 1:8978 UNITED LN STE 102
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-3668
Practice Address - Country:US
Practice Address - Phone:740-274-4246
Practice Address - Fax:740-249-4944
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LCDCIII.162624101YA0400X
OH163735101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)