Healthcare Provider Details

I. General information

NPI: 1457276701
Provider Name (Legal Business Name): BLUE HERON COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 OXFORD ST STE A
SUMTER SC
29150-3353
US

IV. Provider business mailing address

5 ELLEN DR
SUMTER SC
29150-3749
US

V. Phone/Fax

Practice location:
  • Phone: 803-232-8190
  • Fax:
Mailing address:
  • Phone: 864-325-8619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH REED
Title or Position: OWNER
Credential: LPC
Phone: 864-325-8619