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INNOVATIVE COMMUNITY RESOURCE SPECIALIST
NPI 1003121724
Counselor - Professional in Oklahoma City, OK

Active since August 18, 2010
3535 NW 58TH ST STE 870E, OKLAHOMA CITY, OK 73112(405) 205-8346 Get Directions Write a Review

NPPES record last updated: December 3, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Innovative Community Resource Specialist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INNOVATIVE COMMUNITY RESOURCE SPECIALIST (NPI 1003121724) is a healthcare organization registered as a professional in Oklahoma City, Oklahoma and active in the NPI registry since August 2010. The organization lists Leesa Lacey, President, as its authorized official.

NPPES Registry Identity

NPI1003121724
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameINNOVATIVE COMMUNITY RESOURCE SPECIALIST
Location Address3535 NW 58TH ST STE 870EOklahoma City, OK 73112-4804
Mailing Address3535 Nw 58th St Ste 870eOklahoma City, OK 73112-4804 · (405) 702-9032 · Fax (405) 702-9031
Phone(405) 205-8346
Organization SubpartNo
Authorized OfficialLeesa LaceyPresident · (405) 702-9032
Enumeration DateAugust 18, 2010
Last NPPES UpdateDecember 3, 2010
✔ NPI 1003121724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
3535 NW 58TH ST STE 870E, Oklahoma City, OK 73112
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D1072111

Innova, LLC · Oklahoma City, OK
Expired · Jul 8, 2026
CLIA Number37D1072111
Laboratory TypeHome Health Agency
Certificate Effective DateJuly 9, 2024
Certificate Expiration DateJuly 8, 2026
Laboratory DirectorSharita Coleman
Laboratory Phone(405) 604-9172
Laboratory LocationInnova, LLC4100 Perimeter Center Drive Suite 210, Oklahoma City, OK 73112
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Innovative Community Resource Specialist's NPI number?

The NPI number for Innovative Community Resource Specialist is 1003121724. It was assigned to this organization in the NPPES registry on August 18, 2010.

Where is Innovative Community Resource Specialist located?

Innovative Community Resource Specialist is located at 3535 NW 58th St Ste 870E, Oklahoma City, OK 73112. The listed phone number is (405) 205-8346.

What is Innovative Community Resource Specialist's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Innovative Community Resource Specialist was last updated on December 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.