MEDICARE: 333 THE WELLNESS OASIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1730043803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	333 THE WELLNESS OASIS

Provider Business Mailing Address
First Line	:	2274 SALEM RD SE # 1216
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	678-374-9791
Fax Number	:

Provider Business Practice Location Address
First Line	:	2274 SALEM RD SE # 1216
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30013-2097
Country	:	US
Telephone Number	:	678-374-9791
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIKA A YOUNG
Credential	:	LPC
Telephone Number	:	678-343-1696

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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