Healthcare Provider Details

I. General information

NPI: 1518897107
Provider Name (Legal Business Name): SANKOFA MIND AND SOUL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NE 100TH ST
OKLAHOMA CITY OK
73131-3345
US

IV. Provider business mailing address

2400 NE 100TH ST
OKLAHOMA CITY OK
73131-3345
US

V. Phone/Fax

Practice location:
  • Phone: 405-821-7767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: THERESE COOPER-CHANDLER
Title or Position: PRESIDENT/LPC
Credential:
Phone: 405-821-7767