Healthcare Provider Details

I. General information

NPI: 1891465621
Provider Name (Legal Business Name): CLARE CONWAY LPCC, ATR, RYT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11328 EUCLID AVE APT 203
CLEVELAND OH
44106-3978
US

IV. Provider business mailing address

6200 FIR AVE
CLEVELAND OH
44102-3913
US

V. Phone/Fax

Practice location:
  • Phone: 216-453-8073
  • Fax:
Mailing address:
  • Phone: 440-426-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number21-044
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.2303454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: