Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carolyn Denise Jackson, LCSW, LCAS-A

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1689805657

Carolyn Denise Jackson, LCSW, LCAS-A is a Clinical Social Worker in Wilmington, North Carolina. Graduated from Brody School of Medicine at East Carolina University in 2009, 17 years ago. Practices as a sole proprietor, works from 5 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
17
Trained at
Brody School of Medicine at East Carolina University
Licensed in
NC
In the registry since
2009
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3205 Randall Pkwy Ste 121
Wilmington, NC 28403
Phone: (910) 520-6083
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 44 Dream Ave, Delco, NC 28436-8700 — (910) 655-0698
  • 3205 Randall Pkwy Ste 121, Wilmington, NC 28403 — (910) 520-6083
  • 610 Varsity Dr, Wilmington, NC 28403-8444 — (910) 520-6083
  • 1213 Culbreth Dr, Wilmington, NC 28405-3639 — (910) 520-6083

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C011298 (NC)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 22913 (NC)

Record details

NPI number1689805657
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , LCAS-A
Sole proprietorYes
NPI enumeratedAugust 7, 2009
Last updated in NPPESMay 4, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolBRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated 2009 (17 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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