NPIMap

Organization Active NPI

Trail Ahead Therapy, LLC

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1235733437
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRAIL AHEAD THERAPY, LLC
Practice address
901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059
Phone
(505) 249-2798
Fax
(505) 355-2611
NPI assigned
Nov 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Ingrid Lucia Bisbee, LCSWNPI 1467953570
Title
Owner, Psychotherapist
Phone
(505) 702-8112

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Case Management Agency 251B00000X
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X

Addresses

Primary practice location

901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059

Mailing address

901 Rio Grande Blvd NW Ste G252
Albuquerque, NM 87104-2059
Phone (505) 249-2798

Other practice location 1

2055 S Pacheco St Ste 500
Santa Fe, NM 87505-3994
Phone (505) 702-8112 ext. 2

Other identifiers 1

IdentifierTypeStateIssuer
34333088MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201215000387 NM Part B Supplier - Clinic/Group Practice 4789096884 Receives reassigned benefits from 5 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

142 Truman St NE
Ste C
Albuquerque, NM 87108
Phone (505) 249-2798

901 Rio Grande Blvd NW
Ste G252
Albuquerque, NM 87104
Phone (505) 249-2798

2055 S Pacheco St
Ste 500
Santa Fe, NM 87505
Phone (505) 424-0200

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1606521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1235733437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042059",
            "telephone_number": "505-249-2798",
            "fax_number": "505-355-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 RIO GRANDE BLVD NW STE G252",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871042059",
            "telephone_number": "505-249-2798",
            "fax_number": "505-355-2611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 S Pacheco St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875053994",
            "country_code": "US",
            "telephone_number": "505-702-8112 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRAIL AHEAD THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-28",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "BISBEE",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "LUCIA",
        "authorized_official_title_or_position": "OWNER, PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "505-702-8112",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34333088",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.