| Tamar Group Llc | |
|
224 Wacaster St Jackson MS 39209-6307 | |
| (601) 966-0167 | |
| Not Available |
| Full Name | Tamar Group Llc |
|---|---|
| Speciality | Counselor |
| Location | 224 Wacaster St, Jackson, Mississippi |
| Authorized Official Name and Position | Roslyn Smith (CEO/PRESIDENT) |
| Authorized Official Contact | 6019660167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamar Group Llc Po Box 2222 Jackson MS 39225-2222 Ph: (601) 966-0167 | Tamar Group Llc 224 Wacaster St Jackson MS 39209-6307 Ph: (601) 966-0167 |
| NPI Number | 1407267578 |
|---|---|
| Provider Enumeration Date | 05/12/2014 |
| Last Update Date | 05/12/2014 |
| Medicare PECOS PAC ID | 7810291499 |
|---|---|
| Medicare Enrollment ID | O20160202000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407267578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1251 (Mississippi) | Primary |
| Provider Name | Maxie Lerone Gordon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427018613 PECOS PAC ID: 2466406798 Enrollment ID: I20050309000456 |
| Provider Name | Nokita T Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073763967 PECOS PAC ID: 6002137940 Enrollment ID: I20150604000871 |
| Provider Name | Sandra Lampkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841927373 PECOS PAC ID: 5597136382 Enrollment ID: I20230112002849 |
| Provider Name | Samantha Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861063794 PECOS PAC ID: 2668860677 Enrollment ID: I20230119001971 |
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