Provider Demographics
NPI:1891465621
Name:CONWAY, CLARE (LPC, ATR-P)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:CONWAY
Suffix:
Gender:F
Credentials:LPC, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 HERMAN AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2254
Mailing Address - Country:US
Mailing Address - Phone:440-465-6270
Mailing Address - Fax:
Practice Address - Street 1:9637 STATE ROUTE 534
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9516
Practice Address - Country:US
Practice Address - Phone:440-426-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002741101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor