Healthcare Provider Details

I. General information

NPI: 1225498850
Provider Name (Legal Business Name): JOSHUA REGINALD ROYBAL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8208 CALLE PRIMERA NW
ALBUQUERQUE NM
87120-5355
US

IV. Provider business mailing address

8206 LOUISIANA AVE SUITE A
ALBUQUERQUE NM
87113-1738
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-3094
  • Fax:
Mailing address:
  • Phone: 505-226-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWB-2022-0980
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-11483
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: