Innovations Counseling and Consulting Services PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INNOVATIONS COUNSELING AND CONSULTING SERVICES PLLC

Practice address

1905 J N Pease PL Ste 202
Charlotte, NC 28262-4539

Phone

(360) 339-3838

Fax

(704) 981-9567

NPI assigned

Mar 21, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Carmen Davis, PH.DNPI 1063640894

Title

Owner and Clinician

Phone

(360) 339-3838

Specialties & licenses 4

Addresses

Other names 1

• Carmen Davis Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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

• Carmen Davis, PH.D, LCMHCS, NCC

  • Professional Counselor
  • Charlotte, NC
  • NPI 1063640894
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1720780786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 J N PEASE PL STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624539",
            "telephone_number": "360-339-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 J N PEASE PL STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624539",
            "telephone_number": "360-339-3838",
            "fax_number": "704-981-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIONS COUNSELING AND CONSULTING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER AND CLINICIAN",
        "authorized_official_telephone_number": "360-339-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carmen Davis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carmen Davis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.