Individual provider Active NPI

Kelsey Nicole Dudosh

  • Behavior Technician
  • Fayetteville, NC
National Provider Identifier
1174437842
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2346 Williamwood LN
Fayetteville, NC 28314-8914
Phone
(910) 981-2063
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NC Primary

Addresses

Primary practice location

2346 Williamwood LN
Fayetteville, NC 28314-8914

Mailing address

4747 Old Spears Rd
Fayetteville, NC 28304-5129
Phone (910) 981-2063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1174437842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 OLD SPEARS RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283045129",
            "telephone_number": "910-981-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2346 WILLIAMWOOD LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283148914",
            "telephone_number": "910-981-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDOSH",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.