Healthcare Provider Details

I. General information

NPI: 1386532166
Provider Name (Legal Business Name): HELENE ROYBAL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 1ST ST NW
ALBUQUERQUE NM
87102-1529
US

IV. Provider business mailing address

3912 DOROTEO PL NE
ALBUQUERQUE NM
87111-3841
US

V. Phone/Fax

Practice location:
  • Phone: 505-766-5197
  • Fax:
Mailing address:
  • Phone: 505-378-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: