Individual provider Active NPI

Wardell Barksdale Jr., LGSW

  • Addiction (Substance Use Disorder) Counselor
  • Baltimore, MD
National Provider Identifier
1780968172
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
G08097 Issued in MD
Practice address
2225 N Charles St
Baltimore, MD 21218-5778
Phone
(443) 573-8673
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X G08097 MD Primary

Addresses

Primary practice location

2225 N Charles St
Baltimore, MD 21218-5778

Mailing address

3218 Massachusetts Ave
Baltimore, MD 21229-3765
Phone (410) 945-5899

Other identifiers 1

IdentifierTypeStateIssuer
G08097OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
G08097MDMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1780968172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 MASSACHUSETTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212293765",
            "telephone_number": "410-945-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185778",
            "telephone_number": "443-573-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKSDALE",
        "first_name": "WARDELL",
        "name_suffix": "Jr.",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "G08097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G08097",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.