CAPTIVE HEARTS NPI 1457975351

NPI Information

  • NPI: 1457975351
  • Provider Name: CAPTIVE HEARTS
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Address: 882 W GRAND AVE
    GROVER BEACH, CA
    ZIP 93433
  • Phone: (805) 481-4500

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NPI Details

CAPTIVE HEARTS is an addiction (substance use disorder) counselor in Grover Beach, CA. CAPTIVE HEARTS NPI is 1457975351. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

882 W GRAND AVE
GROVER BEACH, CA
ZIP 93433-134
Phone: (805) 481-4500

The provider's authorized official is Elissa Rose Goodenough .
The authorized official title is Board Member/ Employee and has the following contact phone number (805) 602-8751.

The enumeration date for this NPI number is 6/5/2020 and was last updated on 6/17/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1172A00000XDriverNo
2103TR0400XPsychologistRehabilitationNo
3101YP2500XCounselorProfessionalNo
4101YM0800XCounselorMental HealthNo
5101YP1600XCounselorPastoralNo
6101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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