Healthcare Provider Details

I. General information

NPI: 1134042153
Provider Name (Legal Business Name): CARLISHA BARKSDALE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-2167
US

IV. Provider business mailing address

2204 BUNKER HILL RD NE
WASHINGTON DC
20018-3129
US

V. Phone/Fax

Practice location:
  • Phone: 292-984-2414
  • Fax:
Mailing address:
  • Phone: 202-984-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: