Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Paul Bodine Jr.

Individual provider Peer Specialist · NPI 1417682790

Kenneth Paul Bodine Jr. is a Peer Specialist in Ashtabula, Ohio. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

2801 C Ct
Ashtabula, OH 44004-4577
Phone: (440) 998-0722
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X

Record details

NPI number1417682790
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 20, 2022
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022

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