Organization Active NPI

Trailside Therapy & Wellness LLC

  • Clinical Social Worker
  • Grand Junction, CO
National Provider Identifier
1245039767
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TRAILSIDE THERAPY & WELLNESS LLC
Practice address
661 Turnberry CT
Grand Junction, CO 81504-6018
Phone
(970) 640-6028
NPI assigned
Mar 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Angela Paul, LCSW, LACNPI 1407614928
Title
Owner
Phone
(970) 462-7333

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

661 Turnberry CT
Grand Junction, CO 81504-6018

Mailing address

661 Turnberry CT
Grand Junction, CO 81504-6018
Phone (970) 640-6028

Other names 1

  • Trailside Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1741392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1245039767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 TURNBERRY CT",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815046018",
            "telephone_number": "970-640-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 TURNBERRY CT",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815046018",
            "telephone_number": "970-640-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAILSIDE THERAPY & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-08",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-462-7333",
        "authorized_official_credential": "LCSW, LAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trailside Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trailside Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.