Provider Demographics
NPI:1306480942
Name:SANKOFA CONSULTING AND COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:SANKOFA CONSULTING AND COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-339-3860
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:AR
Mailing Address - Zip Code:72107-0003
Mailing Address - Country:US
Mailing Address - Phone:501-339-3860
Mailing Address - Fax:833-653-6333
Practice Address - Street 1:2223 WASHINGTON AVE STE C
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-2765
Practice Address - Country:US
Practice Address - Phone:501-339-3860
Practice Address - Fax:833-653-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty