Provider Demographics
NPI:1215767181
Name:BODIFORD, BARBARA MOORE (LCSW, DSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MOORE
Last Name:BODIFORD
Suffix:
Gender:F
Credentials:LCSW, DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:ALTHA
Mailing Address - State:FL
Mailing Address - Zip Code:32421-0206
Mailing Address - Country:US
Mailing Address - Phone:850-272-0500
Mailing Address - Fax:
Practice Address - Street 1:27905 STATE ROAD 71 N
Practice Address - Street 2:
Practice Address - City:ALTHA
Practice Address - State:FL
Practice Address - Zip Code:32421-2817
Practice Address - Country:US
Practice Address - Phone:850-272-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical