Provider Demographics
NPI:1356511265
Name:TRNOVSKY, ABIGAIL J (LISCW)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:J
Last Name:TRNOVSKY
Suffix:
Gender:F
Credentials:LISCW
Other - Prefix:MS
Other - First Name:ABIGAIL
Other - Middle Name:J
Other - Last Name:GINGRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:835 CENTRAL AVE STE 126
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2506
Mailing Address - Country:US
Mailing Address - Phone:603-652-1091
Mailing Address - Fax:
Practice Address - Street 1:15 OLD ROLLINSFORD RD STE 302
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2819
Practice Address - Country:US
Practice Address - Phone:603-742-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3089550Medicaid
ME1356511265Medicaid
NHS400228009Medicare PIN