Individual
LAKEISHA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2775 CRUSE RD STE 601, LAWRENCEVILLE, GA 30044-7142
(770) 744-1740
(770) 759-1009
Mailing address
2440 WISTERIA DR UNIT 769, SNELLVILLE, GA 30078-1967
(770) 744-1740
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
GA
101YP1600X
Pastoral Counselor
—
GA
171400000X
Health & Wellness Coach
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/25/2025
Last updated
01/13/2026
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