Provider Demographics
NPI:1114098670
Name:WESTBAY, ROBERT MICHAEL III (LISW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:WESTBAY
Suffix:III
Gender:M
Credentials:LISW
Other - Prefix:MR
Other - First Name:R.
Other - Middle Name:MICHAEL
Other - Last Name:WESTBAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:4607 JAMAICA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2839
Mailing Address - Country:US
Mailing Address - Phone:505-332-8256
Mailing Address - Fax:
Practice Address - Street 1:1503 UNIVERSITY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1708
Practice Address - Country:US
Practice Address - Phone:505-243-2551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI - 21631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical