Active NPI
Marlaina Raye Stevenson, CCC-SLP
- Speech-Language Pathologist
- Morgantown, WV
National Provider Identifier
1285759167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP-1062
- Practice address
- 161 Bakers Ridge Rd
Morgantown, WV 26508-1459 - Phone
- (304) 285-0692
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 05368 | MD | |
| Speech-Language Pathologist | 235Z00000X | SLP-1062 | WV | Primary |
Addresses
Primary practice location
161 Bakers Ridge Rd
Morgantown, WV 26508-1459
Mailing address
1035 Mapletown Rd
Greensboro, PA 15338-1001
Phone (724) 943-3677
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49303 | Other | VITAL STIM | |
| 12078256 | Other | NOMS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 05368 | MD | MD | Speech-Language Pathologist |
| SLP-1062 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1285759167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 MAPLETOWN RD",
"city": "GREENSBORO",
"state": "PA",
"postal_code": "153381001",
"telephone_number": "724-943-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 BAKERS RIDGE RD",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265081459",
"telephone_number": "304-285-0692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENSON",
"first_name": "MARLAINA",
"middle_name": "RAYE",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "05368",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WV",
"license": "SLP-1062",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VITAL STIM",
"identifier": "49303",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NOMS",
"identifier": "12078256",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.