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SANKOFA BEHAVIORAL HEALTH SERVICES LLC
NPI 1710589205
Clinic/Center - Adult Mental Health in Jacksonville, FL

Active since November 10, 2020
5379 LENOX AVE, JACKSONVILLE, FL 32205(904) 891-6614(904) 512-6614 Get Directions Write a Review

NPPES record last updated: November 10, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sankofa Behavioral Health Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANKOFA BEHAVIORAL HEALTH SERVICES LLC (NPI 1710589205), doing business as Dr. Mia R. Wilson, is a healthcare organization registered as an adult mental health in Jacksonville, Florida and active in the NPI registry since November 2020. The organization lists Mia R Wilson, Lmhc, as its authorized official.

NPPES Registry Identity

NPI1710589205
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameSANKOFA BEHAVIORAL HEALTH SERVICES LLC
Location Address5379 LENOX AVEJacksonville, FL 32205-4737
Mailing AddressPo Box 8056Jacksonville, FL 32239-0056 · (904) 891-6614 · Fax (904) 512-6614
Phone(904) 891-6614
Fax(904) 512-6614
Organization SubpartNo
Authorized OfficialMia R WilsonLmhc · (904) 891-6614
Enumeration DateNovember 10, 2020
NPPES CertifiedNovember 10, 2020
✔ NPI 1710589205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
5379 LENOX AVE, Jacksonville, FL 32205
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Other Names 1

Doing Business AsDr. Mia R. Wilson

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LARRY TYRONE RICHARDSON PH.D., LMHC
Counselor (Mental Health)
5379 LENOX AVE
JACKSONVILLE, FL 32205
Duval County (904) 378-9955
DR. MIA R WILSON ED.D
Counselor (Mental Health)
5379 LENOX AVE
JACKSONVILLE, FL 32205
Duval County (904) 891-6614

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sankofa Behavioral Health Services LLC's NPI number?

The NPI number for Sankofa Behavioral Health Services LLC is 1710589205. It was assigned to this organization in the NPPES registry on November 10, 2020. The provider is doing business as Dr. Mia R. Wilson.

Where is Sankofa Behavioral Health Services LLC located?

Sankofa Behavioral Health Services LLC is located at 5379 Lenox Ave, Jacksonville, FL 32205. The listed phone number is (904) 891-6614.

What is Sankofa Behavioral Health Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Sankofa Behavioral Health Services LLC was last updated on November 10, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.