Provider Demographics
NPI:1679535603
Name:SHERMAN HAYES, CAROL (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:SHERMAN HAYES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MILLS RD P.O.BOX 43
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553-9998
Mailing Address - Country:US
Mailing Address - Phone:845-629-8413
Mailing Address - Fax:845-258-4611
Practice Address - Street 1:18 BELVEDERE RD
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543
Practice Address - Country:US
Practice Address - Phone:845-629-8413
Practice Address - Fax:845-258-4611
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR01472011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7338877OtherGHI VALUE OPTIONS
0007029415OtherAETNA
0007029415OtherAETNA