Healthcare Provider Details

I. General information

NPI: 1073401402
Provider Name (Legal Business Name): SALINA CONNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 CLINTON AVE
CLEVELAND OH
44113-2808
US

IV. Provider business mailing address

4269 PEARL RD
CLEVELAND OH
44109-4234
US

V. Phone/Fax

Practice location:
  • Phone: 216-678-8084
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.190805
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: