NPIMap

Organization Active NPI

Innovation Counseling Services Inc

  • Mental Health Counselor
  • Laurel, MD
National Provider Identifier
1306583349
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
INNOVATION COUNSELING SERVICES INC
Practice address
8400 Snowden Loop
Laurel, MD 20708-2358
Phone
(240) 838-2245
NPI assigned
May 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Adedayo AdealaNPI 1003258971
Title
President
Phone
(240) 917-1380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

8400 Snowden Loop
Laurel, MD 20708-2358

Mailing address

8400 Snowden Loop
Laurel, MD 20708-2358
Phone (240) 838-2245

Other identifiers 1

IdentifierTypeStateIssuer
1003258971MedicaidMD

Other names 2

  • Build and Make Doing business as
  • Innovation Counseling Services Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL innocounseling.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250110002152 DC Part B Supplier - Clinic/Group Practice 4385172824 Receives reassigned benefits from 1 practitioner
Practice locations: Laurel, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1306583349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 SNOWDEN LOOP",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082358",
            "telephone_number": "240-838-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 SNOWDEN LOOP",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082358",
            "telephone_number": "240-838-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-19",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "ADEALA",
        "authorized_official_first_name": "ADEDAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-917-1380"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003258971",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "innocounseling.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8400 Snowden Loop",
            "city": "Laurel",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207082358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Build and Make",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Innovation Counseling Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Innovation Counseling Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.