Individual provider Active NPI

Jeannine Marie Haney-Fryberger, LMHC

  • Mental Health Counselor
  • Cocoa, FL
National Provider Identifier
1104522960
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH26110 Issued in FL
Practice address
600 Florida Ave Unit 101
Cocoa, FL 32923-5006
Phone
(321) 408-4213
Fax
(321) 404-0131
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH26110 FL Primary
Mental Health Counselor 101YM0800X MI-0000376 DE

Addresses

Primary practice location

600 Florida Ave Unit 101
Cocoa, FL 32923-5006

Mailing address

PO Box 560203
Rockledge, FL 32956-0203
Phone (321) 408-4213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730003352 FL Practitioner - Mental Health Counselor 9739696956 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MI-0000376DEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Jul 28, 2025 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Jul 1, 2025 Accepting new patients
Eventide Therapy Mental Health PastSince Oct 5, 2025 Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1104522960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 560203",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329560203",
            "telephone_number": "321-408-4213",
            "fax_number": "321-404-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FLORIDA AVE UNIT 101",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329235006",
            "telephone_number": "321-408-4213",
            "fax_number": "321-404-0131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY-FRYBERGER",
        "first_name": "JEANNINE",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH26110",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "MI-0000376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.