Organization Active NPI

Wildbrook Psychiatry, LLC

  • Psychiatry Physician
  • Marietta, GA
National Provider Identifier
1013826874
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WILDBROOK PSYCHIATRY, LLC
Practice address
1229 Johnson Ferry Rd Ste 204C
Marietta, GA 30068-5416
Phone
(770) 588-8665
NPI assigned
Sep 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cecilia Lau, MD
Title
Psychiatrist
Phone
(770) 588-8665

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

1229 Johnson Ferry Rd Ste 204C
Marietta, GA 30068-5416

Mailing address

1229 Johnson Ferry Rd Ste 204C
Marietta, GA 30068-5416

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1013826874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 JOHNSON FERRY RD STE 204C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 JOHNSON FERRY RD STE 204C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685416",
            "telephone_number": "770-588-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDBROOK PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "CECILIA",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "770-588-8665",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.