Provider Demographics
NPI:1801628557
Name:LANDES, HAYLEY MORGAN FARRELL (LCSW)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MORGAN FARRELL
Last Name:LANDES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-3336
Mailing Address - Country:US
Mailing Address - Phone:207-548-2475
Mailing Address - Fax:207-548-2470
Practice Address - Street 1:37 MORTLAND RD
Practice Address - Street 2:
Practice Address - City:SEARSPORT
Practice Address - State:ME
Practice Address - Zip Code:04974-3336
Practice Address - Country:US
Practice Address - Phone:207-548-2475
Practice Address - Fax:207-548-2470
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC233551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical