Charlotte Jenice Heron, MA PSYCHOLOGY

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF61546501 Issued in WA

Practice address

8284 28TH CT NE Ste a
Lacey, WA 98516-7161

Phone

(360) 559-1506

NPI assigned

May 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Charlotte Jenice Boggs-Heron Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Northwest Therapy Group PLLC

  • Mental Health Counselor
  • Lacey, WA
  • NPI 1497372460
  Medicare reassignment NPD

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1396123766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8284 28TH CT NE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985167161",
            "telephone_number": "360-559-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8284 28TH CT NE STE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985167161",
            "telephone_number": "360-559-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERON",
        "first_name": "CHARLOTTE",
        "middle_name": "JENICE",
        "name_prefix": "Mrs.",
        "credential": "MA PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MG60660327",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF61546501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLOTTE",
            "last_name": "BOGGS-HERON",
            "middle_name": "JENICE",
            "prefix": "MRS.",
            "credential": "BOGGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Herbert Todd DDS
• Cynthia Herbert, M.S.
• Michael Herman, PHARMD
• Karla Hernandez
• Heron Cove Counseling & Consulting, PLLC
• Maria Delores Herrera
• Thomas J Herrick, DDS
• Rosalind Latrice Herrington-Moxon
• Kaitlyn Paige Herrmann, PA
• Sarah Hershberger, CBT

• Marriage & Family Therapist in Lacey, WA
• Providers in Lacey, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.