Provider Demographics
NPI:1790041119
Name:NIBBE, DRINA R
Entity Type:Individual
Prefix:
First Name:DRINA
Middle Name:R
Last Name:NIBBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 MALETA LN STE 204
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7609
Mailing Address - Country:US
Mailing Address - Phone:720-598-2551
Mailing Address - Fax:
Practice Address - Street 1:753 MALETA LN STE 204
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108
Practice Address - Country:US
Practice Address - Phone:720-598-2551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
COLPC.0012951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health