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

Active since April 03, 2018PECOS EnrolledAccepts Medicare Assignment
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: July 19, 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
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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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Raven Brundige Lpccs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

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.

Frequently Asked Questions

What is Raven Brundige's NPI number?

The NPI number assigned to this healthcare provider is 1912403510, enumerated as an "individual" on April 03, 2018.

Where is the provider located?

The provider is located at 722 HOLLYWOOD LN MANSFIELD, OH 44907 and the phone number is (567) 274-9226.

What is the provider's specialty?

Counselor with taxonomy code 101YP2500X and a focus in Professional.

What insurance does Raven Brundige accept?

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource,. Please consult your insurance carrier or call the provider to verify.