BLUE HERON NEUROFEEDBACK AND COUNSELING
NPI 1669039178
Clinic/Center - Multi-Specialty in Conway, NH
About Blue Heron Neurofeedback And Counseling NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE HERON NEUROFEEDBACK AND COUNSELING (NPI 1669039178) is a healthcare organization registered as a multi-specialty in Conway, New Hampshire and active in the NPI registry since May 2019. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Stacie L Leclerc, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 6
Secondary Practice Locations 2
Other Identifiers 8
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blue Heron Neurofeedback And Counseling is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Blue Heron Neurofeedback And Counseling, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 30D2330333
Blue Heron Neurofeedback & Counseling · Gorham, NHCertificate of Waiver 30D2330336
Blue Heron Neurofeedback & Counseling · Littleton, NHFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blue Heron Neurofeedback And Counseling's NPI number?
The NPI number for Blue Heron Neurofeedback And Counseling is 1669039178. It was assigned to this organization in the NPPES registry on May 21, 2019.
Where is Blue Heron Neurofeedback And Counseling located?
Blue Heron Neurofeedback And Counseling is located at 379 White Mountain Hwy, Conway, NH 03818. The listed phone number is (603) 356-6400.
What is Blue Heron Neurofeedback And Counseling's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Blue Heron Neurofeedback And Counseling enrolled in Medicare?
Yes. Blue Heron Neurofeedback And Counseling is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blue Heron Neurofeedback And Counseling?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Blue Heron Neurofeedback And Counseling, in Mental Health Counselor and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Blue Heron Neurofeedback And Counseling hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Blue Heron Neurofeedback And Counseling accept?
Health plans from Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Shield and WellSense Health Plan list Blue Heron Neurofeedback And Counseling as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Blue Heron Neurofeedback And Counseling was last updated on November 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blue Heron Neurofeedback And Counseling · NPI 1669039178
Multi-Specialty organization in Conway, New Hampshire. Organization record, active in the CMS NPPES registry since May 21, 2019.
## Identity
- **NPI:** 1669039178 (Entity type: Organization)
- **Enumerated:** May 21, 2019
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Stacie Leclerc, OWNER
## Practice location
- **Address:** 379 WHITE MOUNTAIN HWY, Conway, NH 03818-4206
- **Phone:** (603) 356-6400 · **Fax:** (603) 413-4666
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Mental Health Counselor (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 11, 2025
- **Other identifiers:** Medicaid 3138509 (NH); Medicaid 3147125 (NH); Medicaid 3118551 (NH); and 5 more
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1669039178) · Data from the CMS NPPES public registry.