Provider Demographics
NPI:1790851418
Name:TRAINOR, KELLY L (LICSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:L
Last Name:TRAINOR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 BEECH ST
Mailing Address - Street 2:FL 2
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-3137
Mailing Address - Country:US
Mailing Address - Phone:480-220-3942
Mailing Address - Fax:
Practice Address - Street 1:718 SMYTH RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-7007
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:603-629-3244
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2140211041C0700X
MA1155481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical