CAROLYN DENISE JACKSON


Address: 3205 Randall Pkwy Ste 121, Wilmington, NC 28403
Phone: 9105206083

CAROLYN DENISE JACKSON (NPI# 1689805657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689805657
Entity Type Individual
Full Name CAROLYN DENISE JACKSON
Credential LCSW, LCAS-A
Practice Address 3205 Randall Pkwy Ste 121
Wilmington
NC 28403
Mailing Address 3205 Randall Pkwy Ste 121
Wilmington
NC 28403-2567
Practice Telephone 9105206083
Mailing Telephone 9105206083
Enumeration Date 2009-08-07
Last Update Date 2019-05-04
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
22913 NC Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
C011298 NC Behavioral Health & Social Service Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1213 Culbreth Dr, Wilmington, NC 284053639 9105206083
3205 Randall Pkwy Ste 121, Wilmington, NC 28403 9105206083
44 Dream Ave, Delco, NC 284368700 9106550698
610 Varsity Dr, Wilmington, NC 284038444 9105206083

Other Providers CAROLYN JACKSON

NPI Name Taxonomy Address Enumeration
1417428251 Carolyn Jackson Registered Nurse 12502 Beauline Abbey St, Tomball, TX 77377-9017 2018-12-05
1407223233 Carolyn Jackson Dietitian, Registered 1139 Yale Pl, Charlotte, NC 28209-1437 2015-08-27
1750779187 Carolyn E Jackson Physical Therapist 737 Se Main St, Ste 200, Simpsonville, SC 29681-3262 2015-01-08
1386984284 Carolyn Ann Jackson Registered Nurse 926 Perry Ave, Dillon, SC 29536-4734 2013-03-01
1356453591 Carolyn Marie Jackson Social Worker 380 E Fort Lowell Rd Ste 120, Tucson, AZ 85705-3981 2006-08-31
1023063823 Carolyn A Jackson Nurse Practitioner 37984 Airport Rd, Woodsfield, OH 43793-9247 2006-05-23
1568972065 Carolyn Louise Jackson Case Manager/Care Coordinator 6666 Green Valley Cir, Culver City, CA 90230-7068 2017-10-10
1740723972 Carolyn Jackson In Home Supportive Care 301 Main St Ste 2200, Baton Rouge, LA 70801-0014 2016-11-20
1821460742 Carolyn Jackson Social Worker 11616 Southfork Ave, Baton Rouge, LA 70816-5241 2015-10-30
1780074294 Carolyn Anece Jackson Occupational Therapist 2450 Riverside Ave, R102, Minneapolis, MN 55454-1450 2015-02-04

Office Location

Street Address 3205 RANDALL PKWY STE 121
City WILMINGTON
State NC
Zip Code 28403

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902413875 Ymca of Southeastern Nc Health Educator 2710 Market Street, Wilmington, NC 28403 2020-09-25
1659917334 Noa Alper Occupational Therapist 5412 Old Garden Road, Wilmington, NC 28403 2019-11-18
1992346340 Nancy Rosita Carson Technician 5608 Locke Str. Apt 108, Wilmington, NC 28403 2019-10-07
1912484585 Jennifer Nicole Perry Behavior Technician 349 Campus Cv, Wilmington, NC 28403 2018-07-25
1386159929 Monumental Foundations LLC Clinic/Center Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 2017-12-05
1114445731 Jacqulyn Craichy Speech-Language Pathologist 75 Cavalier Drive, Wilmington, NC 28403 2017-09-04
1730638545 Ashley Mcneil Durable Medical Equipment & Medical Supplies 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 2016-09-22
1306204276 Valerie Pringle Jones Physical Therapist 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 2016-02-05
1689039992 Lifeline Treatment Center Clinic/Center 5710 Oleander Dr Ste 100, Wilmington, NC 28403 2015-12-31
1750758264 Melissa Beatson Speech-Language Pathologist 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 2015-09-01
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821602608 Bhs Counseling, Pllc Social Worker 446 Motts Creek Rd, Wilmington, NC 28412-7854 2020-08-31
1659985406 Kelsey Metz Social Worker 2023 S 17th St Unit 1a, Wilmington, NC 28401-6600 2020-08-31
1265044424 Katelyn Elizabeth Currie Social Worker 3401 Wilshire Blvd Apt 103, Wilmington, NC 28403-4261 2020-08-19
1114539467 Personal Insight Therapy, LLC Social Worker 226 Lowell St Ste B7, Wilmington, MA 01887-3073 2020-08-18
1336751726 Ikia Williams Social Worker 4415 Junction Park Dr, Wilmington, NC 28412-2263 2020-08-18
1356961627 Jacqueline Sabella Social Worker 1608 Queen St, Wilmington, NC 28401-5527 2020-04-16
1649808528 Jessie Therese Redden Social Worker 5235 W Woodmill Dr Ste 47, Wilmington, DE 19808-4068 2020-03-27
1659907830 Danielle M Lopez Social Worker 2700 Silverside Rd Ste 4, Wilmington, DE 19810-3724 2020-03-19
1942836267 Christiana Care Health Initiatives Social Worker 4000 Nexus Dr Rm Nwg -250, Wilmington, DE 19803-3000 2020-03-18
1952936049 Taylor Danielle Quick-smith Social Worker 1002 Talcon Dr, Wilmington, DE 19804-1200 2020-03-09
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Competitor

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City WILMINGTON
Zip Code 28403

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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