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Organization
YELLOW BRICK ROAD LLC
Active
Organization
YELLOW BRICK ROAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKEISHA WILSON (DIRECTOR)
(678) 330-7298
Entity
Organization
Contact information
Practice address
2775 CRUSE RD STE 601, LAWRENCEVILLE, GA 30044-7142
(678) 330-7298
Mailing address
2440 WISTERIA DR UNIT 769, SNELLVILLE, GA 30078-1967
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/14/2023
Last updated
01/13/2026
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