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Organization
MIND OVER MAYHEM LLC
Active
Organization
MIND OVER MAYHEM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARAH NIEBURG LCSW (OWNER)
(434) 987-4323
Entity
Organization
Contact information
Practice address
5102 GUNPOWDER RD, FAIRFAX, VA 22030-6510
(434) 987-4323
Mailing address
5102 GUNPOWDER RD, FAIRFAX, VA 22030-6510
(434) 987-4323
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30018130450001
—
VA
Enumeration date
02/03/2025
Last updated
09/24/2025
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