Healthcare Provider Details

I. General information

NPI: 1023985454
Provider Name (Legal Business Name): TAILORED WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 7TH AVE E STE E
HENDERSONVILLE NC
28792-2890
US

IV. Provider business mailing address

526 CARDWELL LN
FLETCHER NC
28732-0658
US

V. Phone/Fax

Practice location:
  • Phone: 828-490-1112
  • Fax:
Mailing address:
  • Phone: 828-490-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR WRAY LUDWIG
Title or Position: OWNER
Credential: LCSW LCAS
Phone: 252-565-6735