Healthcare Provider Details

I. General information

NPI: 1952604480
Provider Name (Legal Business Name): HUMAN TECHNOLOGIES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 GENESEE ST
UTICA NY
13502-5104
US

IV. Provider business mailing address

1500 GENESEE ST
UTICA NY
13502-5104
US

V. Phone/Fax

Practice location:
  • Phone: 315-735-9501
  • Fax: 315-735-9769
Mailing address:
  • Phone: 315-735-9501
  • Fax: 315-735-9769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SEBASTIAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 315-724-9891