Individual
CORY J BONGIVENGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 E PARK AVE, NILES, OH 44446-2352
(330) 544-8005
Mailing address
487 JUDITH LN, STRUTHERS, OH 44471-1215
(330) 717-1860
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C.2506704-TRNE
OH
171M00000X
Case Manager/Care Coordinator
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
05/20/2026
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