Ellen Lee Dudley, MA LPC CRC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

3295 Issued in NC

Practice address

2018 Eastwood Rd
Suite 316
Wilmington, NC 28403-7228

Phone

(910) 344-0480

Fax

(910) 344-1206

NPI assigned

Oct 26, 2006

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 5, 2024 through Jan 5, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1346325586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SPENCER CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123463",
            "telephone_number": "910-274-6757",
            "fax_number": "910-344-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 EASTWOOD RD",
            "address_2": "SUITE 316",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037228",
            "telephone_number": "910-344-0480",
            "fax_number": "910-344-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "ELLEN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MA LPC CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "3295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103368",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DRS Salling and Tate
• Caitlin Marie Drum, PA
• Toni Anne Drumm, CRNP
• Daniel Kai Dube, DMD
• Robin Beth Duchene, DPT
• Tiffney Ann Dudley, LPC
• Caitlyn Nicole Duffy
• Christine Leah Duffy, MS,CCC-SLP
• Daniel A Duffy, LAT, ATC
• Daniel Joseph Duffy Jr., D.M.D.

• Counselor in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.