Tahisa Jamison

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00352100

Practice address

67 Walnut Ave Ste 207
Clark, NJ 07066-1640

Phone

(732) 982-2888

Fax

(847) 859-5885

NPI assigned

Oct 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328
  Medicare reassignment NPD
• New Jersey Behavioral Health P.C

  • Psychologist
  • Princeton Junction, NJ
  • NPI 1538744297
  NPD (past)
• PHC of Buffalo Grove Clinical Psychology

  • Psychologist
  • Vernon Hills, IL
  • NPI 1235430612
  NPD (past)

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1770058703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORN PKWY STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611454",
            "telephone_number": "847-737-8768",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 WALNUT AVE STE 207",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661640",
            "telephone_number": "732-982-2888",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 Cranbury Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "East Brunswick",
            "state": "NJ",
            "postal_code": "088167600",
            "country_code": "US",
            "telephone_number": "732-982-2888",
            "fax_number": "847-859-5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMISON",
        "first_name": "TAHISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "37AC00352100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Its All Behavior LLC
• Ivn Dental LLC
• Mary Jackson
• Leigh Anne Jadro, CCC-SLP
• James Aragona, MD PA
• Jeanette Janvier
• Syamala Jasti, DMD
• Svetlana Jayson, AGPCNP-BC
• Robert E Jensen, LPN
• Elizabeth A Jessen, OTR

• Mental Health Counselor in Clark, NJ
• Providers in Clark, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.