Individual provider Active NPI

Leon Andrew Sankofa Sr., LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1588334544
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904013309 Issued in VA
Practice address
3001 W Mercury Blvd
Hampton, VA 23666-3930
Phone
(757) 380-0385
Fax
(757) 380-0385
NPI assigned
Sep 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111050 TX
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X VA
Clinical Social Worker 1041C0700X 0904013309 VA Primary

Addresses

Primary practice location

3001 W Mercury Blvd
Hampton, VA 23666-3930

Mailing address

PO Box 7502
Hampton, VA 23666-0502
Phone (757) 380-0385

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0904013309VAMDClinical Social Worker
111050TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Parallel Behavior Services Multi-Specialty CurrentSince Sep 28, 2021 Accepting new patients

Locations

3001 W Mercury Blvd
Hampton, VA 23666
Phone (757) 380-0385

Organizations & group practices 1

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": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1588334544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7502",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236660502",
            "telephone_number": "757-380-0385",
            "fax_number": "757-380-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W MERCURY BLVD",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663930",
            "telephone_number": "757-380-0385",
            "fax_number": "757-380-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKOFA",
        "first_name": "LEON",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "111050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.