Provider Demographics
NPI:1497322101
Name:BONDS, SHAMIKA (MSW)
Entity Type:Individual
Prefix:
First Name:SHAMIKA
Middle Name:
Last Name:BONDS
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 1:107 MARTIN LUTHER KING DR
Mailing Address - Street 2:
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-1833
Mailing Address - Country:US
Mailing Address - Phone:334-661-5678
Mailing Address - Fax:
Practice Address - Street 1:9283 W US HIGHWAY 84
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36345-3634
Practice Address - Country:US
Practice Address - Phone:334-661-5678
Practice Address - Fax:334-692-4457
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)