Healthcare Provider Details

I. General information

NPI: 1528655180
Provider Name (Legal Business Name): CHANDLER HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1099
US

IV. Provider business mailing address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1099
US

V. Phone/Fax

Practice location:
  • Phone: 617-665-1185
  • Fax:
Mailing address:
  • Phone: 617-665-1185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW1143059
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: