Provider Demographics
NPI:1700385069
Name:GRIEGO, ROBERT CARLOS (MSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CARLOS
Last Name:GRIEGO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MILLER CIR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-2819
Mailing Address - Country:US
Mailing Address - Phone:505-712-5985
Mailing Address - Fax:
Practice Address - Street 1:3705 MILLER CIR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-2819
Practice Address - Country:US
Practice Address - Phone:505-712-5985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-10285104100000X
NMM-10444104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker