MEDICARE: CHARITY LYNN TRAINHAM MSW INTERN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	122534	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942787700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARITY LYNN TRAINHAM MSW INTERN

Provider Business Mailing Address
First Line	:	50 DIETZ ST STE J
Second Line	:
City	:	ONEONTA
State	:	NY
Zip	:	13820-1865
Country	:	US
Telephone Number	:	315-269-4859
Fax Number	:	315-779-1184

Provider Business Practice Location Address
First Line	:	6278 PINE GROVE RD
Second Line	:
City	:	GLENFIELD
State	:	NY
Zip	:	13343-1805
Country	:	US
Telephone Number	:	315-771-1683
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2018
Last Update Date	:	12/05/2024

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