NPIMap

Organization Active NPI

Sankofa Healing & Wellness, PLLC

  • Mental Health Counselor
  • Champaign, IL
National Provider Identifier
1811649783
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SANKOFA HEALING & WELLNESS, PLLC
Practice address
701 Devonshire Dr Ste C19
Champaign, IL 61820-7352
Phone
(309) 431-5381
NPI assigned
Jan 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Imani Harrison, LCPCNPI 1861968240
Title
Owner
Phone
(217) 255-0346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

701 Devonshire Dr Ste C19
Champaign, IL 61820-7352

Mailing address

701 Devonshire Dr Ste C19
Champaign, IL 61820-7352
Phone (217) 255-0346

National Provider Directory

National Provider Directory
Tax ID family
The Vitality Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1811649783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE C19",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207352",
            "telephone_number": "217-255-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE C19",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207352",
            "telephone_number": "309-431-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANKOFA HEALING & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-21",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "IMANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-255-0346",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.