=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659276848
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHOLE HEART THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/09/2026
-----------------------------------------------------
Last Update Date | 10/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 B AVE
-----------------------------------------------------
City | KALONA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52247-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-214-9129
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1580 480TH ST SW
-----------------------------------------------------
City | KALONA
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52247-9243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-530-3788
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE OWNER/CLINICIAN
-----------------------------------------------------
Name | BETHANY ROBERTS
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 319-530-3788
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------