Sophia Bankole, IMH

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH23555 Issued in FL

Practice address

4546 N Federal Hwy
Ft Lauderdale, FL 33308-5204

Phone

(954) 716-6514

Fax

(754) 223-2984

NPI assigned

Dec 16, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theracounsel, Inc.Group PAC ID 0143206466, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Theracounsel, Inc.

  • Clinical Social Worker
  • Fort Lauderdale, FL
  • NPI 1457460339
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1780491522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4546 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085204",
            "telephone_number": "954-716-6514",
            "fax_number": "754-223-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4546 N FEDERAL HWY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333085204",
            "telephone_number": "954-716-6514",
            "fax_number": "754-223-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKOLE",
        "first_name": "SOPHIA",
        "credential": "IMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH23555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Ballaron, PA-C
• Natalee B Balseiro, LMHC
• Mia Isabel Banag
• Tanisha Bandoo, MS,RDN,CDN,LDN
• Ana Andreea Banica, PA-C
• Sarah Banks
• Stephanie Lauren Banks
• Rose Bannon
• Banyan Recovery Institute
• Banyan Recovery Institute

• Mental Health Counselor in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.