Provider Demographics
NPI:1760892897
Name:YANCEY, MADONNA (LPC, LCDC-I, BCPC)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:
Last Name:YANCEY
Suffix:
Gender:F
Credentials:LPC, LCDC-I, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 JONATHON CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2347
Mailing Address - Country:US
Mailing Address - Phone:832-752-6171
Mailing Address - Fax:
Practice Address - Street 1:7609 JONATHON CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2347
Practice Address - Country:US
Practice Address - Phone:832-752-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YA0400X, 101YM0800X
101YP1600X
TX69680101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral