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General NPI Number Information
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NPI Number | 1457137077
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Entity Type | Organization
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Legal Business Name | YELLOW BRICK ROAD COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 2121 AVENUE E
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City | BIRMINGHAM
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State | AL
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Zip | 35218-1711
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Country | US
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Telephone | 205-603-8435
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Fax |
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Provider Business Mailing Address
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Address Line | 404 HILLVIEW DR
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City | FAIRFIELD
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State | AL
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Zip | 35064-1736
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Country | US
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Telephone | 205-584-2539
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAWANDA LAMELL
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Credential | ALC
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Telephone | 205-584-2539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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