Individual provider Active NPI

Charlotte Trenholm, MSW, LICSW, MLADC

  • Clinical Social Worker
  • Derry, NH
National Provider Identifier
1215329131
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1382 Issued in NH
Practice address
3 Viza Ave
Derry, NH 03038-5368
Phone
(603) 453-0704
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1382 NH Primary

Addresses

Primary practice location

3 Viza Ave
Derry, NH 03038-5368

Mailing address

3 Viza Ave
Derry, NH 03038-5368
Phone (603) 453-0704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150408001709 NH Practitioner - Clinical Social Worker 5597083261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

300 Hanover St
Manchester, NH 03104-4957
Phone (603) 663-4430

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1382NHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Mar 1, 2025 Accepting new patients
Elliot Hospital of the City of Manchester Past Accepting new patients

Locations

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1215329131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VIZA AVE",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030385368",
            "telephone_number": "603-453-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VIZA AVE",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030385368",
            "telephone_number": "603-453-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENHOLM",
        "first_name": "CHARLOTTE",
        "credential": "MSW, LICSW, MLADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.