Provider Demographics
NPI:1265214191
Name:BLUE HERON COUNSELING, PLLC
Entity type:Organization
Organization Name:BLUE HERON COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMF
Authorized Official - Phone:828-406-7057
Mailing Address - Street 1:161 EASTWOOD BND
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8148
Mailing Address - Country:US
Mailing Address - Phone:828-406-7057
Mailing Address - Fax:
Practice Address - Street 1:719A GREENWAY ROAD
Practice Address - Street 2:ROOM 214
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4816
Practice Address - Country:US
Practice Address - Phone:828-406-7057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty