Provider Demographics
NPI:1649788464
Name:PHILLIPS, HAILEE A (LADC)
Entity type:Individual
Prefix:MS
First Name:HAILEE
Middle Name:A
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:746 STREAM RD
Mailing Address - Street 2:
Mailing Address - City:WINTERPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04496-4420
Mailing Address - Country:US
Mailing Address - Phone:207-478-3742
Mailing Address - Fax:
Practice Address - Street 1:746 STREAM RD
Practice Address - Street 2:
Practice Address - City:WINTERPORT
Practice Address - State:ME
Practice Address - Zip Code:04496-4420
Practice Address - Country:US
Practice Address - Phone:207-478-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LC7738101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty