Healthcare Provider Details

I. General information

NPI: 1306758826
Provider Name (Legal Business Name): JAY YAACOV SCHWARTZ LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 249
CEDARHURST NY
11516-0249
US

IV. Provider business mailing address

PO BOX 249
CEDARHURST NY
11516-0249
US

V. Phone/Fax

Practice location:
  • Phone: 347-707-5664
  • Fax:
Mailing address:
  • Phone: 347-707-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number104038
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: