Provider Demographics
NPI:1295066942
Name:DR. ROBERT WISHNOFF DBA HUMAN RESOURCE ASSOC
Entity type:Organization
Organization Name:DR. ROBERT WISHNOFF DBA HUMAN RESOURCE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WISHNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LMHC
Authorized Official - Phone:518-434-1799
Mailing Address - Street 1:105 SOUTH LAKE AVENUE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-434-1799
Mailing Address - Fax:518-434-1132
Practice Address - Street 1:105 SOUTH LAKE AVENUE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-434-1799
Practice Address - Fax:518-434-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000001-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty