Provider Demographics
NPI:1942787700
Name:TRAINHAM, CHARITY LYNN (MSW INTERN)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:LYNN
Last Name:TRAINHAM
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:LYNN
Other - Last Name:NORTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 DIETZ ST STE J
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1865
Mailing Address - Country:US
Mailing Address - Phone:315-269-4859
Mailing Address - Fax:315-779-1184
Practice Address - Street 1:6278 PINE GROVE RD
Practice Address - Street 2:
Practice Address - City:GLENFIELD
Practice Address - State:NY
Practice Address - Zip Code:13343-1805
Practice Address - Country:US
Practice Address - Phone:315-771-1683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY122534104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3372621Medicaid