Provider Demographics
NPI:1588669386
Name:BIBER, DANIEL CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CHARLES
Last Name:BIBER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-4735
Mailing Address - Country:US
Mailing Address - Phone:794-334-4300
Mailing Address - Fax:704-334-8639
Practice Address - Street 1:1717 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-4735
Practice Address - Country:US
Practice Address - Phone:794-334-4300
Practice Address - Fax:704-334-8639
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC459103TC0700X
NC20106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC03113OtherBLUE CROSS
NCC000001428OtherTRICARE
NC6000184Medicaid
NC6000184Medicaid