| Stacie L Leclerc, | |
|
3277 White Mountain Highway, North Conway, NH 03860 | |
| (603) 356-6400 | |
| Not Available |
| Full Name | Stacie L Leclerc |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 3277 White Mountain Highway, North Conway, New Hampshire |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467636167 | NPI | - | NPPES |
| 3111019 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0960 (New Hampshire) | Secondary |
| 101YM0800X | Counselor - Mental Health | 739 (New Hampshire) | Primary |
| Entity Name | Blue Heron Neurofeedback And Counseling |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669039178 PECOS PAC ID: 5294262044 Enrollment ID: O20241218002466 |
| Mailing Address | Practice Location Address |
|---|---|
| Stacie L Leclerc, 286 Town Hall Rd, Intervale, NH 03845-6108 Ph: (603) 356-6400 | Stacie L Leclerc, 3277 White Mountain Highway, North Conway, NH 03860 Ph: (603) 356-6400 |
Wayne Kieran Cunningham, L.C.M.H.C., L.A.D.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2760 Main Street, Eastern Slope Inn, North Conway, NH 03860 Phone: 603-356-9955 | |
Kelley Marcello, M.ED., LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 16 Norcross Cir, North Conway, NH 03860 Phone: 802-284-8477 | |
Ms. Deborah A Hrdlicka, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 170 Kearsarge Rd, North Conway, NH 03860 Phone: 603-356-4114 Fax: 603-356-4118 | |
Nicholas Hudson-swogger, MA, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 64 Kearsarge Road, North Conway, NH 03860 Phone: 603-493-0562 | |
Stephanie J Kenney, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2977 White Mountain Hwy, North Conway, NH 03860 Phone: 603-651-1441 | |
Adam Kenney, LCMHC, LCPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 2977 White Mountain Hwy, North Conway, NH 03860 Phone: 603-651-1441 |