Provider Demographics
NPI:1053044263
Name:BARKO-ABSHIRE, JODIE (MSW)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:BARKO-ABSHIRE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 S RIDGEWOOD AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-4230
Mailing Address - Country:US
Mailing Address - Phone:386-402-8346
Mailing Address - Fax:
Practice Address - Street 1:2102 S RIDGEWOOD AVE STE 17
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-4230
Practice Address - Country:US
Practice Address - Phone:386-402-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW13147104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker