Individual provider Active NPI

Gina Marie Haney, LMHC, LCMHC

  • Mental Health Counselor
  • East Islip, NY
National Provider Identifier
1487293387
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
19880 Issued in NC
Practice address
107 W Main St
East Islip, NY 11730-2337
Phone
(631) 666-1615
Fax
(631) 666-1709
NPI assigned
Dec 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 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 CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 009525 NY
Mental Health Counselor 101YM0800X 19880 NC Primary

Addresses

Primary practice location

107 W Main St
East Islip, NY 11730-2337

Mailing address

747 Bitting Hall Cir
Rural Hall, NC 27045-9875
Phone (631) 235-7548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240126002872 NY Practitioner - Mental Health Counselor 7517310410 Reassigns benefits to 1 organization
I20250130003128 NC Practitioner - Mental Health Counselor 7517310410 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009525NYMDMental Health Counselor
009525-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC CurrentSince Aug 18, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Single Specialty CurrentSince Aug 18, 2024 Accepting new patients
Sunrise Counseling Center,LTD Single Specialty CurrentSince Jan 15, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, PC Single Specialty Current Accepting new patients

Locations

1101 Marco Dr
Ste 200
Apex, NC 27502
Phone (844) 534-7202

7400 Carmel Executive Park Dr
Ste 155
Charlotte, NC 28226
Phone (844) 534-7208

7029 Albert Pick Rd
Ste 200
Greensboro, NC 27409
Phone (704) 885-0268

107 W Main St
East Islip, NY 11730
Phone (631) 666-1615

Organizations & group practices 4

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": "1577318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1487293387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 BITTING HALL CIR",
            "city": "RURAL HALL",
            "state": "NC",
            "postal_code": "270459875",
            "telephone_number": "631-235-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W MAIN ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302337",
            "telephone_number": "631-666-1615",
            "fax_number": "631-666-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMHC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-26",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009525",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "19880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Islip, NY

Sources for this page

Verify at the official NPI Registry.