Individual provider Active NPI

Antonio Dante Conway, LPCC, LICDC

  • Mental Health Counselor
  • Cleveland, OH
National Provider Identifier
1790284560
Registry record updated Jun 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2505379 Issued in OH
Practice address
3622 Prospect Ave E
Cleveland, OH 44115-2704
Phone
(216) 431-4600
Fax
(216) 431-4601
NPI assigned
Feb 7, 2018
Last updated
Jun 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 162455 OH
Mental Health Counselor 101YM0800X E.2505379 OH Primary

Addresses

Primary practice location

3622 Prospect Ave E
Cleveland, OH 44115-2704

Mailing address

8351 State Route 46
Orwell, OH 44076-9389
Phone (440) 321-9063

Other practice location 1

8351 State Route 46
Orwell, OH 44076-9389
Phone (440) 321-9063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260625000419 MI Practitioner - Mental Health Counselor 4789157363 Reassigns benefits to 1 organization
I20260625000595 IN Practitioner - Mental Health Counselor 4789157363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
162455OHMDAddiction (Substance Use Disorder) Counselor
E.2505379OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
1St Choice Counseling Services LLC Mental Health CurrentSince Jun 29, 2025 Accepting new patients
Imex Inc Addiction (Substance Use Disorder) Past Accepting new patients
Moore Counseling & Mediation Services, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749340800000",
    "number": "1790284560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 STATE ROUTE 46",
            "city": "ORWELL",
            "state": "OH",
            "postal_code": "440769389",
            "telephone_number": "440-321-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 PROSPECT AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152704",
            "telephone_number": "216-431-4600",
            "fax_number": "216-431-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8351 State Route 46",
            "address_purpose": "LOCATION",
            "city": "Orwell",
            "state": "OH",
            "postal_code": "440769389",
            "country_code": "US",
            "telephone_number": "440-321-9063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "ANTONIO",
        "middle_name": "DANTE",
        "name_prefix": "Mr.",
        "credential": "LPCC, LICDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-07",
        "last_updated": "2025-06-08",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162455",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2505379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.