Matthew Sherman Youngberg, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LMFT-3748 Issued in ID

Practice address

859 S Yellowstone Hwy #304
Rexburg, ID 83440-5294

Phone

(208) 313-7464

Fax

(208) 907-0972

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621987200000",
    "number": "1629287354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 S YELLOWSTONE HWY #304",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405294",
            "telephone_number": "208-313-7464",
            "fax_number": "208-907-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 S YELLOWSTONE HWY #304",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405294",
            "telephone_number": "208-313-7464",
            "fax_number": "208-907-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBERG",
        "first_name": "MATTHEW",
        "middle_name": "SHERMAN",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LFMT-3748",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LMFT-3748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002648300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rylee Yorgason, DC
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• Beyron Alexis Zecher, FNP-C
• Zen Portable Massage LLC
• Charles Jeffrey Zollinger, M.D.

• Clinical Social Worker in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.