# TIRZAH WELLNESS CENTER, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588156137
- **Authorized official:** CAROLYN DENISE JACKSON LCSW (CEO)
- **Authorized official phone:** (910) 520-6083

## Contact information

- **Practice address:** 3205 RANDALL PKWY STE 121, WILMINGTON, NC 28403-2567
- **Practice address phone:** (910) 782-8042
- **Practice address fax:** (910) 782-8042
- **Mailing address:** 3205 RANDALL PKWY STE 121, WILMINGTON, NC 28403-2567
- **Mailing address phone:** (910) 782-8042
- **Mailing address fax:** (910) 782-8042

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 251B00000X | Case Management Agency | — | NC | — |
| 251S00000X | Community/Behavioral Health Agency | C011298 | NC | Yes |

## Other

- **Enumeration date:** 05/30/2018
- **Last updated:** 03/29/2023