Individual provider Active NPI

Suwanne Taquise Sancko, LPC

  • Professional Counselor
  • Smyrna, GA
National Provider Identifier
1336752195
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC012989 Issued in GA
Practice address
400 Technology CT SE Ste J
Smyrna, GA 30082-5237
Phone
(770) 431-2354
Fax
(770) 436-7143
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC012989 GA Primary

Addresses

Primary practice location

400 Technology CT SE Ste J
Smyrna, GA 30082-5237

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216003254 GA Practitioner - Mental Health Counselor 2961846019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

400 Technology CT SE
Suite J
Smyrna, GA 30082-5237
Phone (770) 431-2354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Services of Atlanta, LLC Professional CurrentSince Apr 16, 2024 Accepting new patients
Personal Recovery Network LLC Professional CurrentSince Apr 1, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

4006 Holcomb Bridge Rd
Ste 210
Peachtree Corners, GA 30092
Phone (678) 444-4505

1215 Hightower Trl
Ste D102
Sandy Springs, GA 30350
Phone (678) 444-4505

400 Technology Ct SE
Ste J
Smyrna, GA 30082
Phone (770) 431-2354

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1336752195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TECHNOLOGY CT SE STE J",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300825237",
            "telephone_number": "770-431-2354",
            "fax_number": "770-436-7143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCKO",
        "first_name": "SUWANNE",
        "middle_name": "TAQUISE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC012989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.