Provider Demographics
NPI:1124166384
Name:SHERMAN, MICHAEL B (MFT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:B
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5161
Mailing Address - Country:US
Mailing Address - Phone:562-930-9172
Mailing Address - Fax:562-434-8442
Practice Address - Street 1:4137 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-5311
Practice Address - Country:US
Practice Address - Phone:562-433-7652
Practice Address - Fax:562-433-8152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist