Cory J Bongivengo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2608328 Issued in OH

Practice address

165 E Park Ave
Niles, OH 44446-2352

Phone

(330) 544-8005

NPI assigned

May 20, 2019

Last updated

Jun 25, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• National Youth Advocate Program, Inc

  • Community/Behavioral Health Agency
  • Canton, OH
  • NPI 1679721906
  NPD (past)
• National Youth Advocate Program, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rockford, IL
  • NPI 1841943495
  NPD (past)

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

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1912564543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 JUDITH LN",
            "city": "STRUTHERS",
            "state": "OH",
            "postal_code": "444711215",
            "telephone_number": "330-717-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PARK AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462352",
            "telephone_number": "330-544-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIVENGO",
        "first_name": "CORY",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2608328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Blazek
• Rosalyn Blystone, COTA/L
• Charlotte Bobbitt
• Aimee Bonar, PH.D.
• Ashlee Bonar, ED.S.
• Joeleen S Bonner, MOT
• Elise Booker
• Rachael Bordell
• Gina Marie Borowicz, RPH
• Amanda Bortmas

• Mental Health Counselor in Niles, OH
• Providers in Niles, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.