Provider Demographics
NPI:1093982761
Name:SHERIFF, MATTHEW GARY (LMHP, CPC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:GARY
Last Name:SHERIFF
Suffix:
Gender:M
Credentials:LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N 34TH ST
Mailing Address - Street 2:P.O. BOX 2315
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3197
Mailing Address - Country:US
Mailing Address - Phone:402-371-3044
Mailing Address - Fax:402-371-9643
Practice Address - Street 1:200 N 34TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3197
Practice Address - Country:US
Practice Address - Phone:402-371-3044
Practice Address - Fax:402-371-9643
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3551101YM0800X
NE1782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47-083165926Medicaid