NPIMap

Organization Active NPI

Innova Recovery, PLLC

  • Clinical Psychologist
  • Edmond, OK
National Provider Identifier
1497598684
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
INNOVA RECOVERY, PLLC
Practice address
2524 N Broadway # 563
Edmond, OK 73034-4172
Phone
(210) 254-3618
Fax
(210) 881-9022
NPI assigned
Jun 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Authorized official

Name
Kasi Howard
Title
Owner
Phone
(210) 254-3618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2524 N Broadway # 563
Edmond, OK 73034-4172

Mailing address

3502 Paesanos Pkwy Ste 101
San Antonio, TX 78231-1297
Phone (210) 254-3618

National Provider Directory

National Provider Directory
Tax ID family
Innova Recovery PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2524 N Broadway
#563
Edmond, OK 73034

3502 Paesanos Pkwy
Ste 101
San Antonio, TX 78231

Practitioners & affiliated clinicians

Practitioners 2

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": "1718409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718409600000",
    "number": "1497598684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 PAESANOS PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311297",
            "telephone_number": "210-254-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 N BROADWAY # 563",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730344172",
            "telephone_number": "210-254-3618",
            "fax_number": "210-881-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA RECOVERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-15",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "KASI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-254-3618"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.