Sankofa Family Counseling Services, LCSW P.L.L.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SANKOFA FAMILY COUNSELING SERVICES, LCSW P.L.L.C.

Practice address

1400 Portland Ave Ste 54
Rochester, NY 14621-3014

Phone

(585) 491-6646

Fax

(585) 363-5822

NPI assigned

Aug 2, 2019

Organization subpart

No

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

Authorized official

Name

Khadijah Ella Tillman, LCSWNPI 1851618391

Title

Clinical Social Worker

Phone

(585) 713-2071

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 7

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

• Khadijah Ella Tillman, LCSW-R

  • Clinical Social Worker
  • Rochester, NY
  • NPI 1851618391
  Medicare reassignment Care Compare group NPD Authorized official
• Shiann Brown, LMSW

  • Professional Counselor
  • Syracuse, NY
  • NPI 1942873179
  Medicare reassignment Care Compare group NPD
• Latrina Ashton-Harrell, LMSW

  • Social Worker
  • Rochester, NY
  • NPI 1730644006
  Medicare reassignment NPD
• Chrisandra Mareus, LCSW

  • Clinical Social Worker
  • Rochester, NY
  • NPI 1407217730
  Medicare reassignment NPD
• Christal Chantell Dewberry

  • Social Worker
  • Rochester, NY
  • NPI 1942172390
  NPD
• Jarrett Lamar Hannah

  • Mental Health Counselor
  • Rochester, NY
  • NPI 1619658655
  NPD
• Deshawn McLamore, LMSW

  • Social Worker
  • Rochester, NY
  • NPI 1760203681
  NPD

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

{
    "created_epoch": "1564704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1861047292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PORTLAND AVE STE 54",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213014",
            "telephone_number": "585-491-6646",
            "fax_number": "585-363-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PORTLAND AVE STE 54",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213014",
            "telephone_number": "585-491-6646",
            "fax_number": "585-363-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANKOFA FAMILY COUNSELING SERVICES, LCSW P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-02",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "KHADIJAH",
        "authorized_official_middle_name": "ELLA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "585-713-2071",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sankofafamilycounseling.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "1400 Portland Ave Ste 54",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146213014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ayodele Tolulope Sangosanya, M.D.
• Lorenzo Sanguedolce, CRNA
• Aditya Sanjeevi
• Laura Sankey-Balta
• Stephan R Sanko, M.D.
• Jackson Sanna
• Jamie Sanna, NP
• Wassel Sannaa, MBBS
• Madeline Sanquiche
• Eric Sansocie, PHARM D.

• Clinical Social Worker in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.