Organization Active NPI

Heather Groom LLC

Doing business as Heather Groom LCSW Counseling Services

  • Clinical Social Worker
  • Saint Marys, GA
National Provider Identifier
1790677706
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HEATHER GROOM LLC
Doing business as
Heather Groom LCSW Counseling Services
Practice address
4499 Ga Highway 40 E Ste a
Saint Marys, GA 31558-9402
Phone
(843) 513-4935
Fax
(912) 729-4626
NPI assigned
Jul 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
Heather Marie Groom, LCSWNPI 1861188096
Title
Owner
Phone
(843) 513-4935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4499 Ga Highway 40 E Ste a
Saint Marys, GA 31558-9402

Mailing address

4499 Ga Highway 40 E Ste a
Saint Marys, GA 31558-9402
Phone (843) 513-4935

Other names 1

  • Heather Groom LCSW Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251229003349 GA Part B Supplier - Clinic/Group Practice 6507352598 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Marys, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1790677706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 GA HIGHWAY 40 E STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589402",
            "telephone_number": "843-513-4935",
            "fax_number": "912-729-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 GA HIGHWAY 40 E STE A",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315589402",
            "telephone_number": "843-513-4935",
            "fax_number": "912-729-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER GROOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "GROOM",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-513-4935",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heather Groom LCSW Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.