Provider Demographics
NPI:1285755082
Name:BARKSDALE, JOSEPH CLEVELAND (MSW, CAC-1)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CLEVELAND
Last Name:BARKSDALE
Suffix:
Gender:M
Credentials:MSW, CAC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:18664 OAK DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2262
Mailing Address - Country:US
Mailing Address - Phone:313-862-2118
Mailing Address - Fax:313-862-2118
Practice Address - Street 1:8809 JOHN C LODGE BLDG.#5
Practice Address - Street 2:3506 GRATIOT
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-887-6732
Practice Address - Fax:313-876-0532
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010885971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical