Healthcare Provider Details
I. General information
NPI: 1689111452
Provider Name (Legal Business Name): GOOD HEART THERAPY SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/31/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
GOOD HEART THERAPY SERVICES, PLLC 55 CODY DRIVE
POCA WV
25159-9035
US
IV. Provider business mailing address
GOOD HEART THERAPY SERVICES, PLLC 55 CODY DRIVE
POCA WV
25159-9035
US
V. Phone/Fax
- Phone: 304-881-1678
- Fax: 800-796-4730
- Phone: 304-881-1678
- Fax: 800-796-4730
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | DP00942941 |
| License Number State | WV |
VIII. Authorized Official
Name: MRS.
ELISABETH
ANNE
BEARDSLEY
Title or Position: DIRECTOR, PSYCHOTHERAPIST, CLINICAL
Credential: MSW, LICSW
Phone: 304-881-1678