Jacqueline Lee Barksdale, LCSW

Key facts

NPI

1780101501

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

SW3257 (FL)

Practice address

975 Commonwealth Blvd
Tallahasse, FL 32303

Phone

(850) 504-5021

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boys Town North Florida, Inc Emotionally Disturbed Childrens' Residential Treatment Facility · Tallahassee, FL · NPI 1285711960
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780101501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 COMMONWEALTH BLVD",
            "city": "TALLAHASSE",
            "state": "FL",
            "postal_code": "32303",
            "telephone_number": "850-504-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 COMMONWEALTH BLVD",
            "city": "TALLAHASSE",
            "state": "FL",
            "postal_code": "32303",
            "telephone_number": "850-504-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "JACQUELINE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahasse, FL

• Eric Forsthoefel, MD
• Charles B. Hyde, MSW

All providers in Tallahasse, FL · Clinical Social Worker in Florida