Provider Demographics
NPI:1144326851
Name:BROTMAN, JANE BETH (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:BETH
Last Name:BROTMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JANE
Other - Middle Name:BROTMAN
Other - Last Name:AUSTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:715 HILL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3542
Mailing Address - Country:US
Mailing Address - Phone:608-256-0942
Mailing Address - Fax:
Practice Address - Street 1:715 HILL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3542
Practice Address - Country:US
Practice Address - Phone:608-256-0942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1075-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical