Raven Brundige, LPCCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2303797 Issued in OH

Practice address

722 Hollywood LN
Mansfield, OH 44907-1612

Phone

(567) 274-9226

NPI assigned

Apr 3, 2018

Last updated

Jun 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Refuge CounselingGroup PAC ID 0446698898, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Autumn Treatment Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Washington Court House, OH
  • NPI 1225601826
  Medicare reassignment NPD
• Talbot Clinical Services of Ohio LLC

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1053902007
  Medicare reassignment NPD
• Talbot Clinical Services of Ohio LLC

  • Professional Counselor
  • Toledo, OH
  • NPI 1245635549
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OH, Professional

  Medicare reassignment NPD
• Refuge Counseling, LLC

  • Mental Health Counselor
  • Ashland, OH
  • NPI 1508463597
  Care Compare group
• Autumn Treatment Center LLC

  • Family Medicine Physician
  • Springfield, OH
  • NPI 1104633221
  NPD
• Talbot Clinical Services of Ohio LLC

  dba Talbot Clinical Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mt Washington, KY
  • NPI 1316646722
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1912403510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 HOLLYWOOD LN",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HOLLYWOOD LN",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071612",
            "telephone_number": "567-274-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNDIGE",
        "first_name": "RAVEN",
        "credential": "LPCCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.2303797-SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D Browning, MD
• Sherry Renee' Browning, L.P.N.
• Bruce a. Martin, M.D., L.L.C.
• Aaron George Brumit, PT
• Kaitlin Grace Brun, MS, AT
• Bryan D. Martz D.D.S., M.S., Inc.
• Colton Allen Bryant
• Elizabeth Ann Bryant
• Kimberly Faye Bryant
• Daigeana Marie Buck

• Professional Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.