Individual provider Active NPI

Haydn Taylor Deal, LCSW

  • Clinical Social Worker
  • Rockport, ME
National Provider Identifier
1417358193
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC17309 Issued in ME
Practice address
15 Anchor Dr Ste 103
Rockport, ME 04856-3847
Phone
(207) 301-5600
Fax
(207) 301-5360
NPI assigned
Sep 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC17309 ME Primary

Addresses

Primary practice location

15 Anchor Dr Ste 103
Rockport, ME 04856-3847

Mailing address

15 Anchor Dr Ste 103
Rockport, ME 04856-3847
Phone (207) 301-5600

Other practice location 1

66 Stone St
Augusta, ME 04330-5227
Phone (207) 626-3455

Other practice location 2

6 Glen Cove Dr
Rockport, ME 04856-4272
Phone (207) 301-8497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625000342 ME Practitioner - Clinical Social Worker 4284146317 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jun 3, 2025 Accepting new patients
Mainehealth CurrentSince Jun 3, 2025 Accepting new patients
Kennebec Valley Mental Health Center PastSince Nov 6, 2000 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

15 Anchor Dr
Ste 103
Rockport, ME 04856
Phone (207) 301-5600

6 Glen Cove Dr
Rockport, ME 04856
Phone (207) 596-8000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1417358193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ANCHOR DR STE 103",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563847",
            "telephone_number": "207-301-5600",
            "fax_number": "207-301-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ANCHOR DR STE 103",
            "city": "ROCKPORT",
            "state": "ME",
            "postal_code": "048563847",
            "telephone_number": "207-301-5600",
            "fax_number": "207-301-5360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Stone St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043305227",
            "country_code": "US",
            "telephone_number": "207-626-3455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Glen Cove Dr",
            "address_purpose": "LOCATION",
            "city": "Rockport",
            "state": "ME",
            "postal_code": "048564272",
            "country_code": "US",
            "telephone_number": "207-301-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAL",
        "first_name": "HAYDN",
        "middle_name": "TAYLOR",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-12",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockport, ME

Sources for this page

Verify at the official NPI Registry.