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Organization
SANKOFA FAMILY COUNSELING SERVICES, LCSW P.L.L.C.
Active
Organization
SANKOFA FAMILY COUNSELING SERVICES, LCSW P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHADIJAH ELLA TILLMAN LCSW (CLINICAL SOCIAL WORKER)
(585) 713-2071
Entity
Organization
Contact information
Practice address
1400 PORTLAND AVE STE 54, ROCHESTER, NY 14621-3014
(585) 491-6646
(585) 363-5822
Mailing address
1400 PORTLAND AVE STE 54, ROCHESTER, NY 14621-3014
(585) 491-6646
(585) 363-5822
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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