Healthcare Provider Details

I. General information

NPI: 1730805649
Provider Name (Legal Business Name): MATTHEW SCHUBERT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10448 W GARVERDALE CT
BOISE ID
83704-5409
US

IV. Provider business mailing address

10448 W GARVERDALE CT
BOISE ID
83704-5409
US

V. Phone/Fax

Practice location:
  • Phone: 208-615-9828
  • Fax:
Mailing address:
  • Phone: 208-615-9828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC12479
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-9697
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: