Provider Demographics
NPI:1144552779
Name:CONWAY COUNSELING LLC
Entity type:Organization
Organization Name:CONWAY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:216-464-3666
Mailing Address - Street 1:3690 ORANGE PL
Mailing Address - Street 2:STE 410
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4464
Mailing Address - Country:US
Mailing Address - Phone:216-464-3666
Mailing Address - Fax:440-708-0255
Practice Address - Street 1:3690 ORANGE PL
Practice Address - Street 2:STE 410
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4464
Practice Address - Country:US
Practice Address - Phone:216-464-3666
Practice Address - Fax:440-708-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-07
Last Update Date:2010-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI09003011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty