Provider Demographics
NPI:1952448243
Name:ROMANISHIN, MATTHEW (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:ROMANISHIN
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:VA BUTLER HEALTH CARE SYSTEM
Mailing Address - Street 2:353 NORTH DUFFY ROAD
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-1138
Mailing Address - Country:US
Mailing Address - Phone:878-271-6730
Mailing Address - Fax:
Practice Address - Street 1:VA PITTSBURGH HEALTH CARE SYSTEM-PITTSBURGH VA MEDICAL
Practice Address - Street 2:4100 ALLEQUIPPA STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219
Practice Address - Country:US
Practice Address - Phone:412-360-6515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0208061041C0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical