BROCK OWEN BODENBENDER LPCC
NPI 1750815452
Counselor - Mental Health in Middleburg Heights, OH

Q: What is Brock Bodenbender's NPI number?

The NPI number for Brock Bodenbender is 1750815452. It was assigned to this individual provider in the NPPES registry on April 19, 2017.

Q: What is Brock Bodenbender's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Brock Bodenbender was last updated on November 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 19, 2017PECOS Enrolled

17951 JEFFERSON PARK RD STE 100, MIDDLEBURG HEIGHTS, OH 44130(440) 879-8517 Get Directions Write a Review

NPPES record last updated: November 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 21, 2022, Nov 17, 2022, Apr 19, 2017 (3 updates tracked since 2017).

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About Brock Owen Bodenbender Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCK OWEN BODENBENDER LPCC (NPI 1750815452) is an individual mental health provider in Middleburg Heights, Ohio, licensed in Ohio (E.2001912) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1750815452

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameBROCK OWEN BODENBENDERCredential: LPCC

Location Address17951 JEFFERSON PARK RD STE 100Middleburg Heights, OH 44130-8439

Mailing Address17951 Jefferson Park Rd Ste 100Middleburg Heights, OH 44130-8439 · (440) 879-8517

Phone(440) 879-8517

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateApril 19, 2017

Last NPPES UpdateNovember 21, 20223 updates tracked since enumeration

NPPES CertifiedNovember 21, 2022

✔ NPI 1750815452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in OH · E.2001912

17951 JEFFERSON PARK RD STE 100, Middleburg Heights, OH 44130

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Secondary Practice Locations 2

Location 112557 Ravenwood DrChardon, OH 44024-9009 · Phone (440) 285-3568

Location 218660 Bagley Rd Ste 101Middleburg Heights, OH 44130-3483 · Phone (440) 879-8517

Other Identifiers 1

Medicaid0267340OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Oscar Health Insurance and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brock Owen Bodenbender Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103261755

PECOS Enrollment IDI20240305002287

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRANSFORMATION WELLNESS LLC

Counselor (Mental Health)