Blue Heron Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

BLUE HERON RECOVERY LLC

Practice address

2015 NE Loop 410
San Antonio, TX 78217-5411

Phone

(210) 291-6426

NPI assigned

Dec 10, 2020

Organization subpart

No

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

Authorized official

Name

Christine M Varela Mayer, PHDNPI 1831782788

Title

Ceo

Phone

(210) 291-6426

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine M Varela Mayer, PHD

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1831782788
  NPD Authorized official
• Kermit Johnson, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1114723343
  NPD
• Casey Terese Meyers, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1760055065
  NPD
• Gregory Thomas Temple, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • San Antonio, TX
  • NPI 1720884067
  NPD

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1861098188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 NE LOOP 410",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175411",
            "telephone_number": "210-291-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 NE LOOP 410",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175411",
            "telephone_number": "210-291-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HERON RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A",
        "authorized_official_last_name": "VARELA MAYER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-291-6426",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabatha Hope Blount, PHD
• Tea Blount
• Barbara Bennett Blow, C-PNP
• Krystal Rose Bludau
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• Blue Skies of Texas Dental, PLLC (1. Blue Skies West Dental and 2. Blues Skies East Dental)
• Blue Skyes Health & Care PLLC

• Substance Use Disorder Rehabilitation Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.