Healthcare Provider Details
I. General information
NPI: 1750634614
Provider Name (Legal Business Name): SYLINA HOLMES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2012
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1265 INTERSTATE PKWY
AUGUSTA GA
30909-6481
US
IV. Provider business mailing address
1225 HOLDEN DR
AUGUSTA GA
30904-3830
US
V. Phone/Fax
- Phone: 706-849-3386
- Fax:
- Phone: 706-955-9224
- Fax: 706-955-9349
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CSW005522 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: