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Organization

SANKOFA THERAPEUTIC CONCEPTS, LLC

Active
Other names
Sankofa Therapeutic Concepts, PLLC
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONITA P HOLMES LISW-CP (OWNER/CLINICAL CONSULTANT)
(803) 207-0993
Entity
Organization

Contact information

Practice address
130 BEN CASEY DR, STE 102, FORT MILL, SC 29708-6567
(803) 386-3064
(866) 591-1741
Mailing address
2879 HIGHWAY 160 W, PMB 4408, FORT MILL, SC 29708-8581
(803) 386-3064
(866) 591-1741

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
8780
SC
1041C0700X
Clinical Social Worker
Primary
C005480
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
F0704137
NC
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
4345
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6006793
NC
Enumeration date
10/17/2008
Last updated
06/01/2011
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