Shanequa Y Holloman, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007923 Issued in VA

Practice address

5400 Joshua Tree Cir
Fredericksburg, VA 22407-9342

Phone

(703) 398-3021

NPI assigned

Mar 20, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1972920528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 JOSHUA TREE CIR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079342",
            "telephone_number": "703-398-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 JOSHUA TREE CIR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224079342",
            "telephone_number": "703-398-3021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Washington Blvd",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "VA",
            "postal_code": "222045703",
            "country_code": "US",
            "telephone_number": "703-228-1600",
            "fax_number": "703-228-1117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLLOMAN",
        "first_name": "SHANEQUA",
        "middle_name": "Y",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holistic Wellness Group LLC
• Elizabeth Holler
• Holley Family Dentistry Fredericksburg
• Amber Graham Hollifield, FNP-C
• Donald Hollinshed
• Nancy Holloran, M.S. CCC-SLP
• Laura M. Holloway, P.A.
• Andrea Nicole O'Connor Holman
• Jannan W Holmes, LCSW
• Brittney Holt, DPT

• Clinical Social Worker in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.