BLUE HERON NEUROFEEDBACK AND COUNSELING (NPI# 1669039178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669039178 |
| Entity Type | Organization |
| Organization Name | BLUE HERON NEUROFEEDBACK AND COUNSELING |
| Practice Address |
3277 White Mountain Hwy North Conway NH 03860-5113 |
| Mailing Address |
286 Town Hall Rd Intervale NH 03845-6108 |
| Practice Telephone | 6033566400 |
| Mailing Telephone | 6033566400 |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2020-09-07 |
| Authorized Official Name | STACIE L LECLERC (OWNER) |
| Authorized Official Telephone | 6033566400 |
| Authorized Official Credential | LCMHC, MLADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 3118551 | 05 |
| Street Address |
3277 WHITE MOUNTAIN HWY |
| City | NORTH CONWAY |
| State | NH |
| Zip Code | 03860-5113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407863632 | Drew G. Smith | Dentist | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2006-08-01 |
| 1063053742 | Maureen Cason Hanlon | Social Worker | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2019-10-03 |
| 1457871410 | Jonathan Williams Dmd Pllc | Dentist | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2017-06-21 |
| 1902339351 | Eric Balas | Massage Therapist | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2017-04-04 |
| 1396973236 | Jonathan Travis Williams | Dentist | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2009-06-30 |
| 1689872335 | Judy Ann Baker | Family Medicine | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2007-07-04 |
| 1821118761 | Maureen Cason Hanlon | Social Worker | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2007-03-31 |
| 1437166584 | White Mountain Oral & Maxillofacial Surgery, PC | Clinic/Center | 3277 White Mountain Hwy, North Conway, NH 03860-5113 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083539 | Anna Ballard Haley | Pharmacist | 32 Mountain Valley Blvd, North Conway, NH 03860 | 2020-11-06 |
| 1013564814 | Jaclyn Maine Macdonald | Physical Therapist | 3037 White Mountain Hwy, North Conway, NH 03860 | 2019-08-26 |
| 1770143323 | Amy Russo | Occupational Therapist | 3073 White Mountian Highway, North Conway, NH 03860 | 2019-06-17 |
| 1992207203 | Truecare Physical Therapy LLC | Physical Therapist | 3304 White Mountain Highway, North Conway, NH 03860 | 2018-03-02 |
| 1740708882 | Cm Resort, LLC | Specialist | 239 Skimobile Road, North Conway, NH 03860 | 2017-09-08 |
| 1639553886 | Jonathan Eldridge | Chiropractor | 3294 White Mountain Highway, North Conway, NH 03860 | 2015-07-17 |
| 1043636004 | Karen Merritt | Community Health Worker | 1529 Mount Washington Hwy, North Conway, NH 03860 | 2014-03-13 |
| 1982027710 | Karen Louise Howe | Occupational Therapy Assistant | 1251 White Mountain Way, Mineral Springs Rehab Center, North Conway, NH 03860 | 2014-01-30 |
| 1518202787 | Maryellen Mccarthy | Occupational Therapy Assistant | 1251 White Mtn Hwy, North Conway, NH 03860 | 2012-11-29 |
| 1255605770 | Christine Wilson | Behavioral Analyst | 16 Norcross Circle, North Conway, NH 03860 | 2012-03-01 |
| Find all providers in zip 03860 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295898708 | Sylvia W. Pollock | Psychologist | 2977 White Mountain Hwy, North Conway, NH 03860-5111 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912504507 | Danielle Jeanne Morse | Psychologist | Thornton Central School, 1886 Nh Route 175, Thornton, NH 03285 | 2020-10-06 |
| 1578177044 | Moira Christine Debois | Psychologist | 2975 Dartmouth College Hwy Ste 1, North Haverhill, NH 03774-4535 | 2020-09-02 |
| 1750993929 | Michelle M. Morrow | Psychologist | 11 Court St Ste 210, Exeter, NH 03833-2745 | 2020-08-19 |
| 1093351991 | Debra Chen | Psychologist | 1 Success Loop Road, Berlin, NH 03570 | 2019-11-26 |
| 1275196016 | Brittany Evelyn St. Jean | Psychologist | 27 Meisner Rd, Salem, NH 03079-2707 | 2019-04-17 |
| 1134695976 | David J. Corriss, Ph.d., Pllc | Psychologist | 180 Locust Street, Dover, NH 03820-4033 | 2018-10-19 |
| 1558812743 | Danielle Gissinger | Psychologist | 147 Congress St Ste D4, Portsmouth, NH 03801-6614 | 2016-10-22 |
| 1407202971 | Julie Marsden, Psyd | Psychologist | 16 Franklin Street, Exeter, NH 03833-0372 | 2016-05-13 |
| 1669842365 | Karen Snyder Badau | Psychologist | 40 Crosby Sreet, Crestwood Center, Milford, NH 03055 | 2015-10-07 |
| 1396176251 | Erin Mckenna Hirsch | Psychologist | 16 Rachel Way, Bedford, NH 03110-4125 | 2013-12-03 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CONWAY |
| Zip Code | 03860 |
Please comment or provide details below to improve the information on BLUE HERON NEUROFEEDBACK AND COUNSELING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.