JORDAN PANGALLO-KOPROWSKI (LPCC, LICDC, LPC) – Professional Counselor, NPI 1639616592
Professional Counselor
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for JORDAN PANGALLO-KOPROWSKI (LPCC, LICDC, LPC)
111 S BEDFORD ST STE 205
BURLINGTON, MA 018035145
Phone: (888) 858-1723
Type: Location
1100, Hospital Drive, East Batavia Heights, Batavia Township, Clermont County, Ohio, 45103, United States
BATAVIA, OH 451031920
Phone: (513) 834-0763
Fax: (513) 873-1567
Type: Location
BrightView, 446, Morgan Street, Gilbert-Sinton Historic District, Walnut Hills, Cincinnati, Hamilton County, Ohio, 45206, United States
CINCINNATI, OH 452062348
Phone: (513) 834-0763
Fax: (513) 873-1567
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: 2025-02-02
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240122003353 | I | Mental Health Counselor | AZ | TBD |
| I20250202000016 | I | Mental Health Counselor | VA | TBD |
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.
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 01803)
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