Sondra Shantel Graham, LCSW
Individual provider Active NPI Clinical Social Worker · Darien, GA
NPI 1376587774 · NPPES record last updated May 22, 2026
Key facts
- NPI
- 1376587774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW004919 (GA)
- Practice address
- 1000 Commissioner Dr
Darien, GA 31305-9487 - Phone
- (912) 437-9300
- Fax
- (912) 437-9481
- NPI assigned
- Jun 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Divine Wellness Partners LLC
Practice addresses (Care Compare)
4680 Lipscomb St NE
Suite 10B
Palm Bay, FL 32905-2928
Phone (321) 364-3758
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW004919 | GA | MD | Clinical Social Worker |
| MSW003847 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divine Wellness Partners, LLC | Clinical | Current |
Accepting new patients |
Locations
4680 Lipscomb St NE
Ste 10B
Palm Bay, FL 32905
Phone (321) 364-3758
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW004919 | GA | Yes |
| Clinical Social Worker | 1041C0700X | MSW003847 | GA |
Addresses
Primary practice location
1000 Commissioner Dr
Darien, GA 31305-9487
Mailing address
1900 Tebeau Street
Mayo Clinic Health System in Waycross
Waycross, GA 31501
Phone (912) 338-6338
Other practice location 1
4680 Lipscomb St NE Ste 10B
Palm Bay, FL 32905-2928
Phone (321) 364-3758
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MSW003847 | Other | GA | STATE LICENSE |
Other names
- Mrs. Sondra Shantel Hicks
Other providers in Darien, GA
- Gateway Behavioral Health Services
- Gateway Community Service Board
- Georgette a. Pronesti
- Donna T. Ginn
- Golden Isles Coastal Medicine, LLC
- Robert A Green
- Mark Allen Haddock
- Saajidah Harris
- Zhane Asare Jackson
- Jehovah-Jireh
All providers in Darien, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.