MEDICARE: ASHLEY ELIZABETH CLEVENSTINE LPC, NCC, CAADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC016104	PA
2	101YM0800X	Mental Health Counselor	PC016104	PA
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	PC016104	PA

General Provider Information

NPI Number	:	1518746239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ELIZABETH CLEVENSTINE LPC, NCC, CAADC

Provider Business Mailing Address
First Line	:	716 CAMBRIA ST
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-1700
Country	:	US
Telephone Number	:	814-509-8110
Fax Number	:

Provider Business Practice Location Address
First Line	:	716 CAMBRIA ST
Second Line	:
City	:	PORTAGE
State	:	PA
Zip	:	15946-1700
Country	:	US
Telephone Number	:	814-509-8110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	02/11/2026

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