Stacie L Leclerc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

739 Issued in NH

Practice address

379 White Mountain Hwy
Conway, NH 03818-4206

Phone

(603) 356-6400

NPI assigned

Dec 18, 2007

Last updated

Jan 30, 2026By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Mental Health Counselor

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Heron Neurofeedback and CounselingGroup PAC ID 5294262044, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Heron Neurofeedback and Counseling

  • Multi-Specialty Clinic/Center
  • Conway, NH
  • NPI 1669039178

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1467636167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 TOWN HALL RD",
            "city": "INTERVALE",
            "state": "NH",
            "postal_code": "038456108",
            "telephone_number": "603-356-6400",
            "fax_number": "603-447-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 WHITE MOUNTAIN HWY",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038184206",
            "telephone_number": "603-356-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Main St",
            "address_purpose": "LOCATION",
            "city": "Gorham",
            "state": "NH",
            "postal_code": "035814901",
            "country_code": "US",
            "telephone_number": "603-356-6400",
            "fax_number": "603-413-4666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Saranac St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "NH",
            "postal_code": "035614089",
            "country_code": "US",
            "telephone_number": "603-356-6400",
            "fax_number": "603-413-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LECLERC",
        "first_name": "STACIE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0960",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3111019",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carolyn Letellier, ABOC
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• Life Examined LLC

• Mental Health Counselor in Conway, NH
• Providers in Conway, NH by specialty
• Mental Health Counselor in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.