Healthcare Provider Details

I. General information

NPI: 1952789372
Provider Name (Legal Business Name): SANKOFA LIFE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 MAIN ST
BELLEVILLE MI
48111-2649
US

IV. Provider business mailing address

46036 MICHIGAN AVE STE 111
CANTON MI
48188-2304
US

V. Phone/Fax

Practice location:
  • Phone: 888-726-5632
  • Fax: 888-726-5632
Mailing address:
  • Phone: 888-726-5632
  • Fax: 888-726-5632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401012332
License Number StateMI

VIII. Authorized Official

Name: MONICA CARRINGTON
Title or Position: DIRECTOR
Credential: MRC, CRC, LPC
Phone: 888-726-5632