Healthcare Provider Details

I. General information

NPI: 1609309145
Provider Name (Legal Business Name): ASHLEY BARKSDALE EDD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 18TH AVE N
COLUMBUS MS
39701-2237
US

IV. Provider business mailing address

617 18TH AVE N
COLUMBUS MS
39701-2237
US

V. Phone/Fax

Practice location:
  • Phone: 662-368-2008
  • Fax: 662-339-8206
Mailing address:
  • Phone: 662-368-2008
  • Fax: 662-339-8206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberAD23-052B
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC10953
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017267
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5726C
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: