Individual provider Active NPI

Cassandra T Wygle, MA LPC-T

  • Mental Health Counselor
  • Green Bay, WI
National Provider Identifier
1629719398
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5283 Issued in WI
Practice address
300 Crooks St
Green Bay, WI 54301-4527
Phone
(920) 436-6800
Fax
(920) 432-5966
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 5283 WI Primary

Addresses

Primary practice location

300 Crooks St
Green Bay, WI 54301-4527

Mailing address

PO Box 22308
Green Bay, WI 54305-2308
Phone (920) 436-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260310001873 PA Practitioner - Mental Health Counselor 5597248427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 W Main St
Fleetwood, PA 19522-1323

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5283WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Concern-Professional Services for Children, Youth & Families CurrentSince Feb 24, 2026 Accepting new patients
Concern-Professional Services for Children, Youth & Families CurrentSince Feb 24, 2026 Accepting new patients
Family Services of Northeast Wisconsin Inc PastSince Apr 10, 2022 Accepting new patients
Family Services of Northeast Wisconsin Inc PastSince Apr 10, 2022 Accepting new patients

Locations

846 S Main St
Towanda, PA 18848
Phone (570) 265-0977

Organizations & group practices 5

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1629719398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22308",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052308",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014527",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYGLE",
        "first_name": "CASSANDRA",
        "middle_name": "T",
        "credential": "MA LPC-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.