Provider Demographics
NPI:1053523779
Name:TRIMBERGER, CHARLES J (MSW,LCSW)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:J
Last Name:TRIMBERGER
Suffix:
Gender:M
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8112 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3356
Mailing Address - Country:US
Mailing Address - Phone:414-332-0650
Mailing Address - Fax:414-431-1071
Practice Address - Street 1:3970 N OAKLAND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-2265
Practice Address - Country:US
Practice Address - Phone:414-332-9096
Practice Address - Fax:414-332-8596
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI709-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39589900Medicaid