Individual provider Active NPI

Phyllis Darlington Havens, RD, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1528275385
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6946 Issued in ME
Practice address
40 Summer St
Bangor, ME 04401-6446
Phone
(207) 990-3896
Fax
(207) 990-3896
NPI assigned
May 17, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC6946 ME Primary
Registered Dietitian 133V00000X D198 ME

Addresses

Primary practice location

40 Summer St
Bangor, ME 04401-6446

Mailing address

60 Kennebec Rd
Hampden, ME 04444-1341
Phone (207) 862-2349

Other identifiers 1

IdentifierTypeStateIssuer
002160OtherMEANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC6946MEMDClinical Social Worker
D198MEMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Past Accepting new patients
Bangor Family Health Care Past Accepting new patients
Mainehealth PastSince Aug 1, 2007 Accepting new patients
Bangor Healthcare Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1528275385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 KENNEBEC RD",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441341",
            "telephone_number": "207-862-2349",
            "fax_number": "207-990-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SUMMER ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016446",
            "telephone_number": "207-990-3896",
            "fax_number": "207-990-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "PHYLLIS",
        "middle_name": "DARLINGTON",
        "name_prefix": "Ms.",
        "credential": "RD, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6946",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "D198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "002160",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.