| Organization Name: | TRAILSIDE HEALTH LLC |
| NPI Number: | 1497175459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEFAN A. TOPOLSKI (CEO) |
| Mailing Address: | 111 Bridge St Shelburne Falls |
| State: | MA US |
| Postal Code: | 013701142 |
| Phone Number: | 4136256240 |
| Fax Number: | 4136256290 |
| NPI Enumeration Date: | 04/17/2014 |
| NPI Last Update Date: | 04/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 1030561 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |