Antonio Dante Conway, LPCC, LICDC
Individual provider Active NPI Mental Health Counselor · Cleveland, OH
NPI 1790284560 · NPPES record last updated Jun 8, 2025
Key facts
- NPI
- 1790284560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- E.2505379 (OH)
- Practice address
- 3622 Prospect Ave E
Cleveland, OH 44115-2704 - Phone
- (216) 431-4600
- Fax
- (216) 431-4601
- NPI assigned
- Feb 7, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- 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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260625000419 | MI | Practitioner - Mental Health Counselor | 4789157363 | Reassigns benefits to 1 organization |
| I20260625000595 | IN | Practitioner - Mental Health Counselor | 4789157363 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162455 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| E.2505379 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 1St Choice Counseling Services LLC | Mental Health | Current |
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 |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 162455 | OH | |
| Mental Health Counselor | 101YM0800X | E.2505379 | OH | Yes |
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
Other providers in Cleveland, OH
- Michael Contorno
- Contract Transport Services, Inc.
- Margaret A Contrera
- Hector Contreras Garza
- Alycia Conway
- Clare Conway
- Courtney Anne Conway
- Devon Scott Conway
- Erin Conway
- Evette Conway
All providers in Cleveland, OH · Mental Health Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.