Active NPI
Sankofa Group
- Mental Health Counselor
- Saint Paul, MN
National Provider Identifier
1689005035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 22145
- Legal business name
- SANKOFA GROUP
- Practice address
- 690 Cleveland Ave S
690 Cleveland Ave Suite 200
Saint Paul, MN 55116-1319 - Phone
- (651) 300-9605
- Fax
- (651) 789-8028
- NPI assigned
- Dec 11, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Nathaniel W Hurse, LICSW/LADC/SAP
- Title
- Founder/Ceo
- Phone
- (612) 203-9809
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 22145 | MN | Primary |
| Clinical Social Worker | 1041C0700X | 22145 | MN |
Addresses
Primary practice location
690 Cleveland Ave S
690 Cleveland Ave Suite 200
Saint Paul, MN 55116-1319
Mailing address
690 Cleveland Ave S
690 S Cleveland Ave Suite 150 St.Paul, MN
Saint Paul, MN 55116-1319
Phone (651) 493-2856
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689005035 | Medicaid | MN |
National Provider Directory
National Provider DirectoryLocations
690 Cleveland Ave S
Ste 200
Saint Paul, MN 55116
Phone (651) 300-9605
690 Cleveland Ave S
Ste 150
Saint Paul, MN 55116
Phone (651) 493-2856
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Saint Paul, MN
- NPI 1457541286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386720000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1490313600000",
"number": "1689005035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 CLEVELAND AVE S",
"address_2": "690 S CLEVELAND AVE SUITE 150 ST.PAUL, MN",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551161319",
"telephone_number": "651-493-2856",
"fax_number": "866-335-3963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 CLEVELAND AVE S",
"address_2": "690 CLEVELAND AVE SUITE 200",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551161319",
"telephone_number": "651-300-9605",
"fax_number": "651-789-8028"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SANKOFA GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-11",
"last_updated": "2017-03-24",
"status": "A",
"authorized_official_last_name": "HURSE",
"authorized_official_first_name": "NATHANIEL",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "FOUNDER/CEO",
"authorized_official_telephone_number": "612-203-9809",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LICSW/LADC/SAP"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "MN",
"license": "22145",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "22145",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689005035",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.