Individual provider Active NPI

Tiffanie Nix

  • Counselor
  • McComb, MS
National Provider Identifier
1790155810
Registry record updated Mar 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3060 Issued in MS
Practice address
1701 White St
McComb, MS 39648-2711
Phone
(601) 249-4217
Fax
(601) 249-4234
NPI assigned
Oct 1, 2015
Last updated
Mar 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3060 MS Primary
Mental Health Counselor 101YM0800X 3060 MS
Professional Counselor 101YP2500X 3060 MS

Addresses

Primary practice location

1701 White St
McComb, MS 39648-2711

Mailing address

2109 Terry Gatesville Rd
Crystal Springs, MS 39059-9749
Phone (601) 281-6014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20260211001193 MS Practitioner - Mental Health Counselor 9638658446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Behavioral Counseling LLCGroup PAC ID 1355604836, 14 clinicians

Practice addresses (Care Compare)

2655 Lakeland Dr
Flowood, MS 39232-9516
Phone (601) 957-7343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3060MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Healthcare- Mississippi LLC CurrentSince Jan 1, 2026 Accepting new patients
Impact Behavioral Counseling LLC Mental Health CurrentSince Jan 1, 2026 Accepting new patients
SW Ms Mental Health Mental Retardation Commission PastSince Jul 1, 2005 Accepting new patients
Southwest Mississippi Mental Health Mental Retardation Commission Past Accepting new patients

Locations

48 Medical Park Dr E
Ste 453
Birmingham, AL 35235
Phone (205) 517-7730

3600 Bluecutt Rd
Ste 202
Columbus, MS 39705
Phone (662) 434-4210

2655 Lakeland Dr
Jackson, MS 39232
Phone (601) 932-8212

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774742400000",
    "number": "1790155810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 TERRY GATESVILLE RD",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390599749",
            "telephone_number": "601-281-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 WHITE ST",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482711",
            "telephone_number": "601-249-4217",
            "fax_number": "601-249-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "TIFFANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2026-03-29",
        "certification_date": "2026-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "3060",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "3060",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "3060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.