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: August 16, 2026.

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

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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

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFERY LEWIS GAYKEN LPC, CAC-I

Counselor (Mental Health)