MEDICARE: ROBERT E DYBALA LCSW, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	8539	TX
2	1041C0700X	Clinical Social Worker	10995	TX

General Provider Information

NPI Number	:	1497885776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E DYBALA LCSW, LPC

Provider Business Mailing Address
First Line	:	1505 HIGHWAY 6 S
Second Line	:	SUITE 195
City	:	HOUSTON
State	:	TX
Zip	:	77077-1700
Country	:	US
Telephone Number	:	281-556-0555
Fax Number	:	281-556-9246

Provider Business Practice Location Address
First Line	:	1505 HIGHWAY 6 S
Second Line	:	SUITE 195
City	:	HOUSTON
State	:	TX
Zip	:	77077-1700
Country	:	US
Telephone Number	:	281-556-0555
Fax Number	:	281-556-9246

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	09/11/2025

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