Individual
MR. MATTHEW SHERMAN YOUNGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
859 S YELLOWSTONE HWY #304, REXBURG, ID 83440-5294
(208) 313-7464
(208) 907-0972
Mailing address
859 S YELLOWSTONE HWY #304, REXBURG, ID 83440-5294
(208) 313-7464
(208) 907-0972
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMFT-3748
ID
106H00000X
Marriage & Family Therapist
LFMT-3748
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002648300
—
ID
Enumeration date
05/21/2007
Last updated
05/26/2021
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