Provider Demographics
NPI:1659072841
Name:HOLMES, SHIRELL (LMSW)
Entity type:Individual
Prefix:
First Name:SHIRELL
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 THOMASTON ST
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:GA
Mailing Address - Zip Code:30295-3387
Mailing Address - Country:US
Mailing Address - Phone:470-720-5459
Mailing Address - Fax:
Practice Address - Street 1:414 S HILL ST FL 2
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4226
Practice Address - Country:US
Practice Address - Phone:470-201-5847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06756700104100000X
GACSW009313104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker