=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821821885
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEAL YOUR ZEN PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2024
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3121 WRIGHTSVILLE AVE
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28403-4111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-617-4675
-----------------------------------------------------
Fax | 910-469-0480
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 16329
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28408-6329
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-460-6161
-----------------------------------------------------
Fax | 910-856-9924
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LORALIE GRIGAS
-----------------------------------------------------
Credential | MSW LCSW
-----------------------------------------------------
Telephone | 910-617-4675
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------