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Organization
BLUE HERON NEUROFEEDBACK AND COUNSELING
Active
Organization
BLUE HERON NEUROFEEDBACK AND COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACIE L LECLERC LCMHC, MLADC (OWNER)
(603) 356-6400
Entity
Organization
Contact information
Practice address
379 WHITE MOUNTAIN HWY, CONWAY, NH 03818-4206
(603) 356-6400
(603) 413-4666
Mailing address
111 SARANAC ST STE 140, LITTLETON, NH 03561-4089
(603) 356-6400
(603) 413-4666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
05/21/2019
Last updated
11/11/2025
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