Provider Demographics
NPI:1003527854
Name:SANKOFA MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:SANKOFA MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MAJORS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-348-3536
Mailing Address - Street 1:1925 WESTRIDGE AVE W # A
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98466-1877
Mailing Address - Country:US
Mailing Address - Phone:253-348-3536
Mailing Address - Fax:253-954-1890
Practice Address - Street 1:1925 WESTRIDGE AVE W # A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98466-1877
Practice Address - Country:US
Practice Address - Phone:253-348-3536
Practice Address - Fax:253-954-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538722640OtherNA