Provider Demographics
NPI:1790900512
Name:HAYWARD, SCOTT A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:A
Last Name:HAYWARD
Suffix:
Gender:M
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:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-0787
Mailing Address - Country:US
Mailing Address - Phone:207-667-0909
Mailing Address - Fax:207-667-6348
Practice Address - Street 1:15 RANGE WAY
Practice Address - Street 2:SUITE 3
Practice Address - City:MANCHESTER
Practice Address - State:ME
Practice Address - Zip Code:04351
Practice Address - Country:US
Practice Address - Phone:207-622-1404
Practice Address - Fax:207-623-7637
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC7850104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker