| Sankofa Holistic Counseling Services, A Professional Clinical Social W | |
|
614 Grand Ave Suite 203 Oakland CA 94610-3554 | |
| (510) 433-0244 | |
| Not Available |
| Full Name | Sankofa Holistic Counseling Services, A Professional Clinical Social W |
|---|---|
| Speciality | Social Worker |
| Location | 614 Grand Ave, Oakland, California |
| Authorized Official Name and Position | Claudius Johnson (CEO) |
| Authorized Official Contact | 5104330244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sankofa Holistic Counseling Services, A Professional Clinical Social W 614 Grand Ave Suite 203 Oakland CA 94610-3554 Ph: (510) 433-0244 | Sankofa Holistic Counseling Services, A Professional Clinical Social W 614 Grand Ave Suite 203 Oakland CA 94610-3554 Ph: (510) 433-0244 |
| NPI Number | 1740602549 |
|---|---|
| Provider Enumeration Date | 01/13/2014 |
| Last Update Date | 02/13/2017 |
| Medicare PECOS PAC ID | 2466736301 |
|---|---|
| Medicare Enrollment ID | O20170221002019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740602549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCS25062 (California) | Primary |
| Provider Name | Claudius Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770738122 PECOS PAC ID: 0244379618 Enrollment ID: I20091124000116 |
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