Healthcare Provider Details

I. General information

NPI: 1750841656
Provider Name (Legal Business Name): TRAILHEAD CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 COLORADO AVE # 200
GLENWOOD SPRINGS CO
81601-3349
US

IV. Provider business mailing address

817 COLORADO AVE # 200
GLENWOOD SPRINGS CO
81601-3349
US

V. Phone/Fax

Practice location:
  • Phone: 970-510-5851
  • Fax:
Mailing address:
  • Phone: 970-510-5851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL JAMES KAIL
Title or Position: THERAPIST/OWNER
Credential: MA, LPC, LCPC
Phone: 970-510-5851