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RUSSELL S. WOLFF PHD NPI 1588890784


NPI Information

NPI: 1588890784
Provider Name: RUSSELL S. WOLFF, PHD
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 33D0984542

Address:
C/O INDEPENDENT LIVING CENTER OF THE HUDSON VALLEY
15-17 THIRD STREET
TROY, NY
ZIP 12180
Phone: (518) 768-0667
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RUSSELL S. WOLFF, PHD is a community behavioral health in Troy, NY. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. RUSSELL S. WOLFF, PHD NPI is 1588890784. The provider is registered as an organization entity type.

The provider's business location address is:

C/O INDEPENDENT LIVING CENTER OF THE HUDSON VALLEY
15-17 THIRD STREET
TROY, NY
ZIP 12180
Phone: (518) 768-0667
Fax: (518) 279-7559

The provider's authorized official is Russell S Wolff .
The authorized official title is Psychologist and has the following contact phone number (518) 768-0667.

The CLIA number assigned to this NPI record is 33D0984542 - school/student health service with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/3/2009 and was last updated on 12/13/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health018097NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103124210MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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