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General NPI Number Information
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NPI Number | 1306480942
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Entity Type | Organization
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Legal Business Name | SANKOFA CONSULTING AND COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 2223 WASHINGTON AVE STE C
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City | CONWAY
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State | AR
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Zip | 72032-2765
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Country | US
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Telephone | 501-339-3860
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Fax | 833-653-6333
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Provider Business Mailing Address
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Address Line | PO BOX 3
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City | MENIFEE
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State | AR
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Zip | 72107-0003
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Country | US
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Telephone | 501-339-3860
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Fax | 833-653-6333
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. CANDACE BAKER
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Credential |
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Telephone | 501-339-3860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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