Provider Demographics
NPI:1669551180
Name:CLEMONS, BARBARA JEAN (CMSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:JEAN
Last Name:CLEMONS
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:JEAN
Other - Last Name:BULLOCKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CMSW
Mailing Address - Street 1:5462 SUNGROVE CIR N
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38135-0294
Mailing Address - Country:US
Mailing Address - Phone:901-388-3032
Mailing Address - Fax:901-388-3032
Practice Address - Street 1:1030 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2127
Practice Address - Country:US
Practice Address - Phone:901-523-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW0000001351104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker