Healthcare Provider Details

I. General information

NPI: 1891601696
Provider Name (Legal Business Name): JAYLEN HARDY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 OAK ST
COPIAGUE NY
11726-3111
US

IV. Provider business mailing address

42 BARCLAY ST
WEST BABYLON NY
11704-2136
US

V. Phone/Fax

Practice location:
  • Phone: 631-312-5751
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132647
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: