Healthcare Provider Details

I. General information

NPI: 1205767472
Provider Name (Legal Business Name): TRAILHEAD INTEGRATED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 RIDGE ST
MOUNT HOPE WV
25880-1340
US

IV. Provider business mailing address

150 RIDGE ST
MOUNT HOPE WV
25880-1340
US

V. Phone/Fax

Practice location:
  • Phone: 304-250-9241
  • Fax:
Mailing address:
  • Phone: 304-250-9241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHELSEY N KEATHLEY
Title or Position: OWNER
Credential: MSW, LGSW
Phone: 304-654-8079