Healthcare Provider Details
I. General information
NPI: 1548121353
Provider Name (Legal Business Name): CHIMAJA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2025
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1330 SAN PEDRO DR NE STE P
ALBUQUERQUE NM
87110-6744
US
IV. Provider business mailing address
6801 JEFFERSON ST NE STE 150
ALBUQUERQUE NM
87109-4379
US
V. Phone/Fax
- Phone: 505-699-8686
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEGRA
LARK
ROYBAL
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 505-699-8686