Organization
TRAIL AHEAD THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INGRID LUCIA BISBEE LCSW (OWNER, PSYCHOTHERAPIST)
(505) 702-8112
Entity
Organization
Contact information
Practice address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2059
(505) 249-2798
(505) 355-2611
Mailing address
901 RIO GRANDE BLVD NW STE G252, ALBUQUERQUE, NM 87104-2059
(505) 249-2798
(505) 355-2611
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34333088
—
NM
Enumeration date
11/28/2020
Last updated
05/15/2023
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