Provider Demographics
NPI:1902698772
Name:THE YELLOW BRIDGE THERAPY CENTER
Entity type:Organization
Organization Name:THE YELLOW BRIDGE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CPCS
Authorized Official - Phone:470-530-9828
Mailing Address - Street 1:1336 COLUMBIA DR STE A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2851
Mailing Address - Country:US
Mailing Address - Phone:470-530-9828
Mailing Address - Fax:
Practice Address - Street 1:7097 SOUTHFACE WAY
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-6361
Practice Address - Country:US
Practice Address - Phone:470-530-9828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty