Innovation Avenue Consulting LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2012005837 Issued in MO

Legal business name

INNOVATION AVENUE CONSULTING LLC

Practice address

606 Davidson CT
Saint Peters, MO 63376-2472

Phone

(314) 246-9249

NPI assigned

Apr 5, 2014

Last updated

Apr 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenyota Maria Dokes, MA. LPCNPI 1750709879

Title

Lead Counselor

Phone

(314) 502-9682

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenyota Dokes, MA., LPC

  • Professional Counselor
  • Saint Peters, MO
  • NPI 1750709879
  Authorized official Same address or phone

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

{
    "created_epoch": "1396656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396656000000",
    "number": "1790103828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1721",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633760050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 DAVIDSON CT",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762472",
            "telephone_number": "314-246-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATION AVENUE CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-05",
        "last_updated": "2014-04-05",
        "status": "A",
        "authorized_official_last_name": "DOKES",
        "authorized_official_first_name": "KENYOTA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "LEAD COUNSELOR",
        "authorized_official_telephone_number": "314-502-9682",
        "authorized_official_credential": "MA. LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2012005837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2014; 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.