Individual provider Active NPI

Cassandra Lynn Wegner, LCPC, CADC

  • Mental Health Counselor
  • Bolingbrook, IL
National Provider Identifier
1497360697
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.0129976 Issued in IL
Practice address
440 W Boughton Rd Ste 200D
Bolingbrook, IL 60440-4510
Phone
(331) 481-9885
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30547 IL
Mental Health Counselor 101YM0800X 180.0129976 IL Primary

Addresses

Primary practice location

440 W Boughton Rd Ste 200D
Bolingbrook, IL 60440-4510

Mailing address

440 W Boughton Rd Ste 200D
Bolingbrook, IL 60440-4510
Phone (331) 481-9885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240709004586 IL Practitioner - Mental Health Counselor 9234674706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

440 W Boughton Rd
Suite 200D
Bolingbrook, IL 60440-4510
Phone (331) 481-9885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30547ILMDAddiction (Substance Use Disorder) Counselor
180.0129976ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pendulum Counseling Services Corp Mental Health CurrentSince Jun 26, 2024 Accepting new patients

Locations

440 W Boughton Rd
Ste 200D
Bolingbrook, IL 60440
Phone (331) 481-9885

900 Jorie Blvd
Ste 110
Oak Brook, IL 60523
Phone (630) 930-1025

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1497360697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 W BOUGHTON RD STE 200D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404510",
            "telephone_number": "331-481-9885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W BOUGHTON RD STE 200D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404510",
            "telephone_number": "331-481-9885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "CASSANDRA",
        "middle_name": "LYNN",
        "credential": "LCPC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30547",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.0129976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.