Healthcare Provider Details

I. General information

NPI: 1699610261
Provider Name (Legal Business Name): WOMENWISE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MELROSE AVE
TRYON NC
28782-3329
US

IV. Provider business mailing address

114 PAGE CREEK BLVD
LANDRUM SC
29356-8836
US

V. Phone/Fax

Practice location:
  • Phone: 303-478-8734
  • Fax:
Mailing address:
  • Phone: 303-478-8734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEE ELIZABETH DUDLEY
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC
Phone: 303-478-8734