Jibreel N Hazly

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Practice address

1225 N Main St
Canton, OH 44720-1959

Phone

(330) 618-5246

NPI assigned

Nov 16, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beautiful Minds Group LLC

  • Homemaker
  • Canton, OH
  • NPI 1982576641

  Intellectual & Developmental Disabilities

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1417559287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 N MAIN ST",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447201959",
            "telephone_number": "330-618-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 N MAIN ST",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447201959",
            "telephone_number": "330-618-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLY",
        "first_name": "JIBREEL",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Elizabeth Hayward, LPCC
• Erin M Haywood
• Paula Haywood, CRNA
• Amy L Hazel, C.N.P.
• Charles Hazly, CDCA
• Jessica Headley, LPCC-S
• Thomas Headley, MS
• Healing Hands Restorative Service
• Healing Happens Here, LLC.
• Health Trends of Ohio LLC (Paramount Home Health)

• Intellectual & Developmental Disabilities Psychologist in Canton, OH
• Providers in Canton, OH by specialty
• Intellectual & Developmental Disabilities Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.