Marion Stephen Clevenger

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2015034337 Issued in MO

Practice address

2124 County Road 15
Boaz, AL 35957-8001

Phone

(256) 557-0228

NPI assigned

Aug 21, 2015

Last updated

Aug 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 9, 2025 through May 9, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1871960112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 COUNTY ROAD 15",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359578001",
            "telephone_number": "256-557-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 COUNTY ROAD 15",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359578001",
            "telephone_number": "256-557-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVENGER",
        "first_name": "MARION",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-21",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2015034337",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "LPC04789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015034337",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Cieszkowski, OD
• City of Boaz (Boaz Fire & Rescue)
• Hollie Claburn, CRNP
• Victoria Clay, RBT
• James Andrew Clement Jr., M.D.
• Clifton Care Inc
• Angela L. Clifton, M.D.
• Douglas Wayne Clink, M.D.
• Ashley Nicole Colquitt, CRNP
• Davis Spine and Sport Recovery LLC

• Mental Health Counselor in Boaz, AL
• Providers in Boaz, AL by specialty
• Mental Health Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.