MEDICARE: 1ST CHOICE COUNSELING SERVICES LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1629965413
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1ST CHOICE COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	8351 STATE ROUTE 46
Second Line	:
City	:	ORWELL
State	:	OH
Zip	:	44076-9389
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 EUCLID AVE STE 891
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44114-3306
Country	:	US
Telephone Number	:	440-385-4044
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTONIO CONWAY
Credential	:	LPCC,LICDC
Telephone Number	:	440-321-9063

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	06/23/2025

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