Healthcare Provider Details

I. General information

NPI: 1497885776
Provider Name (Legal Business Name): ROBERT E DYBALA LCSW, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 HIGHWAY 6 S SUITE 195
HOUSTON TX
77077-1700
US

IV. Provider business mailing address

1505 HIGHWAY 6 S SUITE 195
HOUSTON TX
77077-1700
US

V. Phone/Fax

Practice location:
  • Phone: 281-556-0555
  • Fax: 281-556-9246
Mailing address:
  • Phone: 281-556-0555
  • Fax: 281-556-9246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8539
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10995
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: