Healthcare Provider Details

I. General information

NPI: 1952265217
Provider Name (Legal Business Name): JUSTIN THOMAS BARLOW LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 51761
DURHAM NC
27717-1761
US

IV. Provider business mailing address

PO BOX 51761
DURHAM NC
27717-1761
US

V. Phone/Fax

Practice location:
  • Phone: 828-640-7041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC019241
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: