BLUE HERON WELLNESS LLC
NPI 1679063424
Social Worker - Clinical in Lexington, SC

Q: What is Blue Heron Wellness LLC's NPI number?

The NPI number for Blue Heron Wellness LLC is 1679063424. It was assigned to this organization in the NPPES registry on May 17, 2018.

Q: What is Blue Heron Wellness LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since May 17, 2018

719 S LAKE DR, LEXINGTON, SC 29072(803) 609-7792(803) 816-9058 Get Directions Write a Review

NPPES record last updated: July 20, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 20, 2021, May 17, 2018 (2 updates tracked since 2018).

On this page

About Blue Heron Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE HERON WELLNESS LLC (NPI 1679063424) is a healthcare organization registered as a clinical in Lexington, South Carolina and active in the NPI registry since May 2018. The organization lists Renea Christine Mable, Owner, as its authorized official.

NPPES Registry Identity

NPI1679063424

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameBLUE HERON WELLNESS LLC

Location Address719 S LAKE DRLexington, SC 29072-3432

Mailing Address419 Firebridge DrChapin, SC 29036-7639 · (803) 429-9065

Phone(803) 609-7792

Fax(803) 816-9058

Organization SubpartNo

Authorized OfficialRenea Christine MableOwner · (803) 429-9065

Enumeration DateMay 17, 2018

Last NPPES UpdateJuly 20, 20212 updates tracked since enumeration

NPPES CertifiedJuly 20, 2021

✔ NPI 1679063424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in SC · 10640

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

719 S LAKE DR, Lexington, SC 29072

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blue Heron Wellness Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Blue Heron Wellness LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Renea Mable, LISW-CP

Clinical Social Worker

NPI 1629568472

719 S LAKE DR
Lexington, SC 29072

(803) 609-7792

✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Heron Wellness LLC's NPI number?

The NPI number for Blue Heron Wellness LLC is 1679063424. It was assigned to this organization in the NPPES registry on May 17, 2018.

Where is Blue Heron Wellness LLC located?

Blue Heron Wellness LLC is located at 719 S Lake Dr, Lexington, SC 29072. The listed phone number is (803) 609-7792.

What is Blue Heron Wellness LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Blue Heron Wellness LLC enrolled in Medicare?

Yes. Blue Heron Wellness LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Heron Wellness LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Blue Heron Wellness LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Blue Heron Wellness LLC was last updated on July 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.