BROCK OWEN BODENBENDER (LPCC) – Counselor, NPI 1750815452

BROCK OWEN BODENBENDER (LPCC) is a healthcare provider. based in Chardon, Ohio. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC. They hold a License No. E.2001912 (OH). The NPI Number for BROCK OWEN BODENBENDER (LPCC) is 1750815452

Main info

Male
8 Years Of Experience
Name
BROCK OWEN BODENBENDER (LPCC)
NPI
1750815452
Phone
(440) 285-3568
Address
12557 Ravenwood Dr
Enumeration Date
19 April 2017
Last Update Date
21 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4408798517
Graduation Year
2018 (8 years ago)
PAC ID
6103261755
Group Practice PAC ID
2062889611
Professional Enrollment ID
I20240305002287
Address ID
OH441308439MI17951RDXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for BROCK OWEN BODENBENDER (LPCC)

  • 12557 Ravenwood Dr

    Chardon, OH 440249009

    Phone: (440) 285-3568

    Type: Location

  • 18660 Bagley Rd Ste 101

    Middleburg Heights, OH 441303483

    Phone: (440) 879-8517

    Type: Location

  • 13486 COUNTY ROAD V

    NAPOLEON, OH 435459767

    Phone: (419) 906-0675

    Type: Mailing

  • Ravenwood Mental Health Center, 12557, Ravenwood Drive, Chardon, Claridon Township, Geauga County, Ohio, 44024, United States

    CHARDON, OH 440249009

    Phone: (440) 285-3568

    Type: Location

  • 17951 JEFFERSON PARK RD STE 100

    MIDDLEBURG HEIGHTS, OH 441308439

    Phone: (440) 879-8517

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240305002287IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44024)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062889611View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH
Nurse PractitionerOH
Mental Health CounselorOH
Mental Health CounselorOH
Clinical Social WorkerVA

Reviews

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Frequently asked questions

Does BROCK OWEN BODENBENDER (LPCC) have a public NPI I can cite?
Public records show BROCK OWEN BODENBENDER (LPCC) under NPI 1750815452.
Is BROCK OWEN BODENBENDER (LPCC) currently accepting referrals based on NPI status?
Registry metadata lists BROCK OWEN BODENBENDER (LPCC) as active.
What services align with BROCK OWEN BODENBENDER (LPCC)'s listing?
BROCK OWEN BODENBENDER (LPCC)'s public classification highlights Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit BROCK OWEN BODENBENDER (LPCC) in Chardon, Ohio?
For routing, start with Chardon, Ohio for BROCK OWEN BODENBENDER (LPCC), then verify phone and hours locally.
Why is information missing for BROCK OWEN BODENBENDER (LPCC)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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