NPIMap

Individual provider Active NPI

Jack J. Heddon, M.A., NCC

  • Mental Health Counselor
  • Brattleboro, VT
National Provider Identifier
1164587481
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0122899 Issued in VT
Practice address
51 Fairview Street
Brattleboro, VT 05301-8881
Phone
(802) 254-6028
Fax
(802) 254-7501
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 2593 NH
Professional Counselor 101YP2500X 097.0121746 VT
Mental Health Counselor 101YM0800X 068.0122899 VT Primary

Addresses

Primary practice location

51 Fairview Street
Brattleboro, VT 05301-8881

Mailing address

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4500

Other practice location 1

580 Court St
Keene, NH 03431-1729
Phone (603) 354-5400

Other practice location 2

590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260203000998 NH Practitioner - Mental Health Counselor 0648758458 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial Hospital 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5400

Hospital & facility affiliations

  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
068.0122899VTMDMental Health Counselor
097.0121746VTMDProfessional Counselor
2593NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jan 5, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 5, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 5, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 5, 2026 Accepting new patients
Cheshire Medical Center CurrentSince Jan 5, 2026 Accepting new patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. Past Accepting new patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. Past Accepting new patients

Locations

590 Court St
Keene, NH 03431
Phone (603) 354-5454

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1164587481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 FAIRVIEW STREET",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053018881",
            "telephone_number": "802-254-6028",
            "fax_number": "802-254-7501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "580 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311729",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "590 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311719",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEDDON",
        "first_name": "JACK",
        "middle_name": "J.",
        "credential": "M.A., NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "2593",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VT",
            "license": "097.0121746",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0122899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.