Individual provider Active NPI

Donna Celeste Clevenger

  • School Counselor
  • Salem, VA
National Provider Identifier
1083439301
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
PPS-536174 Issued in VA
Practice address
4549 Malus Dr
Salem, VA 24153-7921
Phone
(540) 562-3900
Fax
(540) 387-6347
NPI assigned
Nov 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X PPS-536174 VA Primary

Addresses

Primary practice location

4549 Malus Dr
Salem, VA 24153-7921

Mailing address

4549 Malus Dr
Salem, VA 24153-7921
Phone (540) 562-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PPS-536174VAMDSchool Counselor

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1083439301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 MALUS DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537921",
            "telephone_number": "540-562-3900",
            "fax_number": "540-387-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4549 MALUS DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537921",
            "telephone_number": "540-562-3900",
            "fax_number": "540-387-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "DONNA",
        "middle_name": "CELESTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "VA",
            "license": "PPS-536174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.