Individual provider Active NPI

Casandra Suzanne Vegwert, LPC

  • Mental Health Counselor
  • Boise, ID
National Provider Identifier
1417646985
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC-9280 Issued in ID
Practice address
8050 W Northview St
Boise, ID 83704-7126
Phone
(208) 327-0504
Fax
(208) 321-8048
NPI assigned
May 2, 2023
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC-9280 ID Primary

Addresses

Primary practice location

8050 W Northview St
Boise, ID 83704-7126

Mailing address

702 Sunset Dr
Ontario, OR 97914-3121
Phone (541) 889-9167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-9280IDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeways, Inc CurrentSince Jan 8, 2024 Accepting new patients
Lifeways, Inc CurrentSince Jan 8, 2024 Accepting new patients
Lifeways, Inc Past Accepting new patients

Locations

8050 W Northview St
Boise, ID 83704
Phone (208) 327-0504

2609 S 10th Ave
Ste 102
Caldwell, ID 83605
Phone (208) 291-1020

824 S Diamond St
Nampa, ID 83686
Phone (208) 546-3046

702 Sunset Dr
Ontario, OR 97914
Phone (541) 823-9041

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1417646985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SUNSET DR",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979143121",
            "telephone_number": "541-889-9167",
            "fax_number": "541-889-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 W NORTHVIEW ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047126",
            "telephone_number": "208-327-0504",
            "fax_number": "208-321-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGWERT",
        "first_name": "CASANDRA",
        "middle_name": "SUZANNE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LPC-9280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.