Healthcare Provider Details

I. General information

NPI: 1639614126
Provider Name (Legal Business Name): YOLANDA DUCEY PHD, BCBA, LPA, LCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YOLANDA WILLIAMS

II. Dates (important events)

Enumeration Date: 12/20/2016
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 BROAD STREET
FUQUAY VARINA NC
27526-3657
US

IV. Provider business mailing address

964 HIGH HOUSE RD # 3135
CARY NC
27513-3574
US

V. Phone/Fax

Practice location:
  • Phone: 479-318-2300
  • Fax:
Mailing address:
  • Phone: 919-337-5394
  • Fax: 919-874-1453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number5926
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number5926
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-36945
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number16959
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5926
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: