BLUE HERON NEUROFEEDBACK AND COUNSELING
NPI 1669039178
Clinic/Center - Multi-Specialty in Conway, NH
NPI Status: Active since May 21, 2019
Contact Information
379 WHITE MOUNTAIN HWY
CONWAY, NH
ZIP 03818
Phone: (603) 356-6400
Fax: (603) 413-4666
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 30D2330336
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 09-14-2027
About BLUE HERON NEUROFEEDBACK AND COUNSELING
This page provides the complete NPI Profile along with additional information for Blue Heron Neurofeedback And Counseling, a provider established in Conway, New Hampshire operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1669039178 assigned on May 2019. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Blue Heron Neurofeedback And Counseling operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Stacie L Leclerc Lcmhc, Mladc (Owner)
- NPI
- 1669039178
- Provider Name
- BLUE HERON NEUROFEEDBACK AND COUNSELING
- Entity Type
- Organization
- Location Address
- 379 WHITE MOUNTAIN HWY CONWAY, NH 03818
- Location Phone
- (603) 356-6400
- Location Fax
- (603) 413-4666
- Mailing Address
- 111 SARANAC ST STE 140 LITTLETON, NH 03561
- Mailing Phone
- (603) 356-6400
- Mailing Fax
- (603) 413-4666
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-21-2019
- Last Update Date
- 11-11-2025
- Code Navigator
Location Map
Secondary Locations
- 111 Saranac St Ste 140
Littleton, NH 03561
(603) 356-6400 - 515 Main St
Gorham, NH 03581
(603) 356-6400
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | |
| 3 | 103TA0400X | Behavioral Health & Social Service Providers | Psychologist | |
| 4 | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | |
| 5 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - EPO
- Choice Bronze HSA + Vision + Adult Dental - EPO
- Clear Silver - EPO
- Clear Silver + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Anthem Bronze Preferred Blue PPO 6000/20%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7000/50%/8000 w/HSA - PPO
- Anthem Bronze Preferred Blue PPO 7500/30%/10000 Value - PPO
- Anthem Bronze Preferred Blue PPO 8500/50%/9200 - PPO
- Anthem Gold Preferred Blue PPO 1000/20%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/0%/6500 RxD - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 2000/10%/7500 - PPO
- Anthem Gold Preferred Blue PPO 2000/20%/4600 w/HSA - PPO
- Anthem Gold Preferred Blue PPO 3000/0%/7500 RxD - PPO
- Anthem Bronze Pathway X Enhanced 6000/35% HSA - HMO
- Anthem Bronze Pathway X Enhanced 7000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway X Enhanced 7500/50% ($0 Virtual PCP + $0 Select Drugs) Standard - HMO
- Anthem Catastrophic Pathway X Enhanced - HMO
- Anthem Gold Pathway X Enhanced 1200/20% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Gold Pathway X Enhanced 2000/25% ($0 Virtual PCP + $0 Select Drug) Standard - HMO
- Anthem Gold Pathway X Enhanced 700/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway X Enhanced 6000/40% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway X Enhanced 4000/0% ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway X Enhanced 4500/20% HSA - HMO
- WellSense Clarity NH Bronze 6500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Bronze 7500 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Bronze 7600 HSA + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Gold 2000 + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 0 Deductible + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 3400 + $0 Rx List + 24/7 Nurse Advice - HMO
- WellSense Clarity NH Silver 6000 + $0 Rx List + 24/7 Nurse Advice - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3138509 | MEDICAID (05) | NH | |
| 3147125 | MEDICAID (05) | NH | |
| 3118551 | MEDICAID (05) | NH | |
| 3149511 | MEDICAID (05) | NH | |
| 3148512 | MEDICAID (05) | NH | |
| 3138507 | MEDICAID (05) | NH | |
| 3138508 | MEDICAID (05) | NH | |
| 3147950 | MEDICAID (05) | NH |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 30D2330336
- Facility Type
- Practitioner Other
- Certificate Effective Date
- September 15, 2025
- Certificate Expiration Date
- September 14, 2027
- Laboratory Director
- LYDIA MCKENZIE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Blue Heron Neurofeedback And Counseling to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1669039178, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669039178, enumerated as an "organization" on May 21, 2019.
The provider is located at 379 WHITE MOUNTAIN HWY CONWAY, NH 03818 and the phone number is (603) 356-6400.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Ambetter from NH Healthy Families, Anthem Blue. Please consult your insurance carrier or call the provider to verify.
