Provider Demographics
NPI:1750863460
Name:YELLOW BRICK ROAD COUNSELING, LLC
Entity Type:Organization
Organization Name:YELLOW BRICK ROAD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICKELL
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, NCC, RPT, LPC
Authorized Official - Phone:888-355-7080
Mailing Address - Street 1:PO BOX 1324
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-1324
Mailing Address - Country:US
Mailing Address - Phone:256-615-2446
Mailing Address - Fax:888-214-9319
Practice Address - Street 1:198 US HIGHWAY 278 E
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-0690
Practice Address - Country:US
Practice Address - Phone:888-355-7080
Practice Address - Fax:256-615-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2505A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
14268521OtherCAQH