| Mrs Shondra Shantel Holmes, LCSW | |
| 
					3280 Mitchell Blvd, Moody Afb, GA 31699-2057  | |
| (229) 257-2778 | |
| Not Available | 
| Full Name | Mrs Shondra Shantel Holmes | 
|---|---|
| Gender | Female | 
| Speciality | Social Worker - Clinical | 
| Location | 3280 Mitchell Blvd, Moody Afb, Georgia | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1649808296 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW006303 (Georgia) | Primary | 
| Entity Name | South Central Primary Care Center, Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891978854 PECOS PAC ID: 1951395920 Enrollment ID: O20040413000249  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Shondra Shantel Holmes, LCSW 3280 Mitchell Blvd, Moody Afb, GA 31699-1500 Ph: (229) 257-2778  | Mrs Shondra Shantel Holmes, LCSW 3280 Mitchell Blvd, Moody Afb, GA 31699-2057 Ph: (229) 257-2778  | 
Mr. Paul J Richardson, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3278 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-5447  | |
Ashley Fink Shapiro, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3278 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-9205  | |
Ms. Kristina Pauline Gardella, MSW, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3280 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-2778  | |
Capri Delvaux,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3280 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-2778  | |
Taylor Murrie-robinson, MSW, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3278 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-2778  | |
Charnell E Smith-akpassa,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3278 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-257-3898 Fax: 229-257-4409  | |
Rachael Dawn Dudley, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3278 Mitchell Blvd, Moody Afb, GA 31699 Phone: 229-262-1000  |