1. Home
  2. Directory
  3. Ohio
  4. Mansfield
  5. Counselor
  6. NPI Profile

RAVEN BRUNDIGE LPCCS
NPI 1912403510
Counselor - Professional in Mansfield, OH

Active since April 03, 2018PECOS Enrolled
722 HOLLYWOOD LN, MANSFIELD, OH 44907(567) 274-9226 Get Directions Write a Review

NPPES record last updated: June 3, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 3, 2025, May 30, 2025, Dec 2, 2024 and 3 more (6 updates tracked since 2020).

About Raven Brundige Lpccs NPPES

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

RAVEN BRUNDIGE LPCCS (NPI 1912403510) is an individual professional provider in Mansfield, Ohio, licensed in Ohio (E.2303797) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1912403510
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameRAVEN BRUNDIGECredential: LPCCS
Location Address722 HOLLYWOOD LNMansfield, OH 44907-1612
Mailing Address722 Hollywood LnMansfield, OH 44907-1612
Phone(567) 274-9226
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 3, 2018
Last NPPES UpdateJune 3, 20256 updates tracked since enumeration
NPPES CertifiedJune 3, 2025
✔ NPI 1912403510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OH · E.2303797
Also ListedCounselorTaxonomy 101Y00000X · License E.2303797-SUPV (OH)
722 HOLLYWOOD LN, Mansfield, OH 44907
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Raven Brundige Lpccs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981041696
PECOS Enrollment IDI20240318000950
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Raven Brundige reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Refuge Counseling, LLC
13 mi
Mental Health
1060 CLAREMONT AVE STE 6
Ashland, OH 44805
  • Reassigned Medicare billing, Ohio enrollment
  • 7 clinicians in this Medicare group
NPI 1508463597 (419) 922-9696
Talbot Clinical Services Of Ohio LLC
81 mi
Family Medicine
732 MAIN ST
Toledo, OH 43605
  • Reassigned Medicare billing, Ohio enrollment
  • Also billed through NPI 1245635549 (Ohio)
  • 31 clinicians in this Medicare group
NPI 1194641811 (419) 691-0600
Autumn Treatment Center LLC
86 mi
Family Medicine
1176 E HOME RD
Springfield, OH 45503
  • Reassigned Medicare billing, Ohio enrollment
  • 36 clinicians in this Medicare group
NPI 1104633221 (614) 943-3839
Grow Healthcare Group PA
1,040 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Ohio enrollment
  • 725 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven Brundige's NPI number?

The NPI number for Raven Brundige is 1912403510. It was assigned to this individual provider in the NPPES registry on April 3, 2018.

Where is Raven Brundige located?

Raven Brundige practices at 722 Hollywood Ln, Mansfield, OH 44907. The listed phone number is (567) 274-9226.

What is Raven Brundige's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Raven Brundige enrolled in Medicare?

Yes. Raven Brundige is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Raven Brundige's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raven Brundige reassigns Medicare benefits to 4 organizations: Refuge Counseling, LLC (Ashland, OH), Talbot Clinical Services Of Ohio LLC (Toledo, OH), Autumn Treatment Center LLC (Springfield, OH) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raven Brundige's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raven Brundige accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 2 other insurers list Raven Brundige as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raven Brundige was last updated on June 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.