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NPI Code Detail

MEDICARE: MR. ANTONIO DANTE CONWAY LPCC, LICDC

MEDICARE: MR. ANTONIO DANTE CONWAY LPCC, LICDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor162455OH
2101YM0800XMental Health CounselorE.2505379OH

General Provider Information

NPI Number : 1790284560
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTONIO DANTE CONWAY LPCC, LICDC
Provider Business Mailing Address
First Line : 8351 STATE ROUTE 46
Second Line :
City : ORWELL
State : OH
Zip : 44076-9389
Country : US
Telephone Number : 440-321-9063
Fax Number :
Provider Business Practice Location Address
First Line : 3622 PROSPECT AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2704
Country : US
Telephone Number : 216-431-4600
Fax Number : 216-431-4601
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2018
Last Update Date : 06/08/2025

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