Individual provider Active NPI

Haley Jackson Mangiafesto, MS, LMHC, LCMHC

  • Mental Health Counselor
  • Gastonia, NC
National Provider Identifier
1548936784
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
20182 Issued in NC
Practice address
111 E 3Rd Ave
Gastonia, NC 28052-4317
Phone
(704) 874-3300
Fax
(704) 874-0065
NPI assigned
Aug 18, 2021
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 20182 NC Primary
Mental Health Counselor 101YM0800X 014125 NY

Addresses

Primary practice location

111 E 3Rd Ave
Gastonia, NC 28052-4317

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1936

Other practice location 1

7400 Carmel Executive Park Dr
Suite 155
Charlotte, NC 28226-8242
Phone (828) 350-1177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241219003314 NC Practitioner - Mental Health Counselor 2163959727

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7400 Carmel Executive Park Dr
Suite 155
Charlotte, NC 28226-8242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
20182NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC CurrentSince Oct 9, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Oct 9, 2024 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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1548936784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1936",
            "fax_number": "704-865-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 3RD AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524317",
            "telephone_number": "704-874-3300",
            "fax_number": "704-874-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7400 Carmel Executive Park Dr",
            "address_2": "Suite 155",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282268242",
            "country_code": "US",
            "telephone_number": "828-350-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGIAFESTO",
        "first_name": "HALEY",
        "middle_name": "JACKSON",
        "credential": "MS, LMHC, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "20182",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.