Sankofa Community Counseling, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFC 49566, LPC 247 Issued in CA

Legal business name

SANKOFA COMMUNITY COUNSELING, INC

Practice address

3705 Haven Ave
Ste 115
Menlo Park, CA 94025-1011

Phone

(650) 454-6109

Fax

(650) 231-2633

NPI assigned

Mar 27, 2014

Organization subpart

No

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

Authorized official

Name

Ms. La Tanya Alicia Takla, LMFT, LPCC

Title

Executive Director

Phone

(650) 454-6109

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1952728933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3082",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940643082",
            "telephone_number": "650-454-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 HAVEN AVE",
            "address_2": "STE 115",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251011",
            "telephone_number": "650-454-6109",
            "fax_number": "650-231-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANKOFA COMMUNITY COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "TAKLA",
        "authorized_official_first_name": "LA TANYA",
        "authorized_official_middle_name": "ALICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "650-454-6109",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT, LPCC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "MFC 49566, LPC 247",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC 49566, LPC 247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.