Healthcare Provider Details

I. General information

NPI: 1578467072
Provider Name (Legal Business Name): YUSEF LATEEF CONAWAY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 E 8TH ST
ANNISTON AL
36207-5731
US

IV. Provider business mailing address

331 E 8TH ST
ANNISTON AL
36207-5731
US

V. Phone/Fax

Practice location:
  • Phone: 256-236-3403
  • Fax: 256-238-6263
Mailing address:
  • Phone: 256-236-3403
  • Fax: 256-238-6263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number04708
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: