# DINAH H NIEBURG, PHD, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841322302
- **Authorized official:** DR. DINAH H NIEBURG PHD (MANAGER)
- **Authorized official phone:** (434) 977-0033

## Contact information

- **Practice address:** 1110 ROSE HILL DR, SUITE 201, CHARLOTTESVILLE, VA 22903-5159
- **Practice address phone:** (434) 977-0033
- **Practice address fax:** (434) 220-3335
- **Mailing address:** 1110 ROSE HILL DR, SUITE 201, CHARLOTTESVILLE, VA 22903-5159
- **Mailing address phone:** (434) 977-0033
- **Mailing address fax:** (434) 220-3335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 0810002889 | VA | Yes |

## Other

- **Enumeration date:** 03/11/2007
- **Last updated:** 06/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 081721M | SENTARA BEHAVIORAL HEALTH | VA |
| 01 | — | 1831126135 | VALUE OPTIONS | VA |
| 01 | — | 1831126135 | VIRGINIA PREMIER | — |
| 01 | — | 208466 | ANTHEM BCBS | VA |