Provider Demographics
NPI:1215329131
Name:TRENHOLM, CHARLOTTE (MSW, LICSW, MLADC)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:TRENHOLM
Suffix:
Gender:F
Credentials:MSW, LICSW, MLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VIZA AVE
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-5368
Mailing Address - Country:US
Mailing Address - Phone:603-453-0704
Mailing Address - Fax:
Practice Address - Street 1:3 VIZA AVE
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-5368
Practice Address - Country:US
Practice Address - Phone:603-453-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical