Healthcare Provider Details
I. General information
NPI: 1760250419
Provider Name (Legal Business Name): BARKSDALE MISSIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2023
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
- Phone: 662-368-2008
- Fax: 662-339-8206
- Phone: 662-368-2008
- Fax: 662-339-8206
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 102L00000X |
| Taxonomy | Psychoanalyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ASHLEY
BARKSDALE
Title or Position: FOUNDER & CLINICAL DIRECTOR
Credential: EDD, LCSW
Phone: 662-368-2008