| Sankofa Counseling Llc | |
|
64 Thompson St Ste A101 East Haven CT 06513 | |
| (203) 928-0807 | |
| (203) 889-2328 |
| Full Name | Sankofa Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 64 Thompson St Ste A101, East Haven, Connecticut |
| Authorized Official Name and Position | Erica S. Reshard (OWNER) |
| Authorized Official Contact | 2039280807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sankofa Counseling Llc P.o. Box 3744 1449 Whalley Avenue New Haven CT 06515-9994 Ph: (203) 928-0807 | Sankofa Counseling Llc 64 Thompson St Ste A101 East Haven CT 06513 Ph: (203) 928-0807 |
| NPI Number | 1871979567 |
|---|---|
| Provider Enumeration Date | 08/04/2015 |
| Last Update Date | 08/16/2018 |
| Medicare PECOS PAC ID | 9133495195 |
|---|---|
| Medicare Enrollment ID | O20171019001789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871979567 | NPI | - | NPPES |
| 008060075 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1142 (Connecticut) | Primary |
| Provider Name | Erica Reshard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699156356 PECOS PAC ID: 7214294412 Enrollment ID: I20171127000468 |
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