Healthcare Provider Details

I. General information

NPI: 1134074115
Provider Name (Legal Business Name): MICHELLE BARKER COUNSELING & CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6639 SOUTHPOINT PKWY STE 106
JACKSONVILLE FL
32216-8042
US

IV. Provider business mailing address

4685 WISTERIA LN
FORTSON GA
31808-6987
US

V. Phone/Fax

Practice location:
  • Phone: 904-891-5900
  • Fax: 904-513-7590
Mailing address:
  • Phone: 904-891-5900
  • Fax: 904-513-7590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE BARKER
Title or Position: MEMBER
Credential:
Phone: 904-891-5900