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Individual

MS. PHYLLIS DARLINGTON HAVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD, LCSW

Contact information

Practice address
40 SUMMER ST, BANGOR, ME 04401-6446
(207) 990-3896
(207) 990-3896
Mailing address
60 KENNEBEC RD, HAMPDEN, ME 04444-1341
(207) 862-2349
(207) 990-3896

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC6946
ME
133V00000X
Registered Dietitian
D198
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002160
ANTHEM BCBS
ME
Enumeration date
05/17/2007
Last updated
09/11/2025
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