Provider Demographics
NPI:1609087550
Name:ROMOTSKY, BURT (LCSW)
Entity Type:Individual
Prefix:
First Name:BURT
Middle Name:
Last Name:ROMOTSKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF CALIFORNIA SANTA BARBARA STUDENT HEALTH
Mailing Address - Street 2:BLDG 588
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93106-7002
Mailing Address - Country:US
Mailing Address - Phone:805-893-3380
Mailing Address - Fax:805-893-4911
Practice Address - Street 1:UNIVERSITY OF CALIFORNIA SANTA BARBARA STUDENT HEALTH
Practice Address - Street 2:BLDG 588
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93106-7002
Practice Address - Country:US
Practice Address - Phone:805-893-3380
Practice Address - Fax:805-893-4911
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS105361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical