Individual provider Active NPI

Carol Sherman Hayes, LCSW

  • Clinical Social Worker
  • Damariscotta, ME
National Provider Identifier
1679535603
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0147201 Issued in NY
Practice address
18 Belvedere Rd
Damariscotta, ME 04543
Phone
(845) 629-8413
Fax
(845) 258-4611
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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 R0147201 NY Primary

Addresses

Primary practice location

18 Belvedere Rd
Damariscotta, ME 04543

Mailing address

106 Mills Rd P.O.Box 43
Newcastle, ME 04553-9998
Phone (845) 629-8413

Other identifiers 2

IdentifierTypeStateIssuer
7338877OtherNYGHI VALUE OPTIONS
0007029415OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060404000814 NY Practitioner - Clinical Social Worker 2769490572 Practice locations: Middletown, NY
I20190729003015 ME Practitioner - Clinical Social Worker 2769490572 Practice locations: Newcastle, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0147201NYMDClinical Social Worker
014720NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jack R Nizewitz & Gary J Lake PC PastSince Oct 27, 2014 Accepting new patients
Sweetser Past Accepting new patients

Organizations & group practices 2

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1679535603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILLS RD P.O.BOX 43",
            "city": "NEWCASTLE",
            "state": "ME",
            "postal_code": "045539998",
            "telephone_number": "845-629-8413",
            "fax_number": "845-258-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 BELVEDERE RD",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "04543",
            "telephone_number": "845-629-8413",
            "fax_number": "845-258-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN HAYES",
        "first_name": "CAROL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0147201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI VALUE OPTIONS",
            "identifier": "7338877",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007029415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Damariscotta, ME

Sources for this page

Verify at the official NPI Registry.