Provider Demographics
NPI:1487712691
Name:CHARLESWORTH, TRINA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:ANN
Last Name:CHARLESWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5477 GLEN LAKES DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0946
Mailing Address - Country:US
Mailing Address - Phone:214-298-8840
Mailing Address - Fax:214-373-6444
Practice Address - Street 1:5477 GLEN LAKES DR
Practice Address - Street 2:SUITE 210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0946
Practice Address - Country:US
Practice Address - Phone:214-298-8840
Practice Address - Fax:214-373-6444
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical