Healthcare Provider Details

I. General information

NPI: 1821951583
Provider Name (Legal Business Name): SCOTT CLEVENSTINE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1398 PAGE ST
PITTSBURGH PA
15233-2007
US

IV. Provider business mailing address

3392 PIN OAK LN
CHALFONT PA
18914-3400
US

V. Phone/Fax

Practice location:
  • Phone: 412-323-3950
  • Fax:
Mailing address:
  • Phone: 215-527-6716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: