Healthcare Provider Details

I. General information

NPI: 1679425870
Provider Name (Legal Business Name): TAMAR CC CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W WOODROW WILSON AVE STE 173-107
JACKSON MS
39213-7681
US

IV. Provider business mailing address

270 TRACE COLONY PARK DR STE B
RIDGELAND MS
39157-8810
US

V. Phone/Fax

Practice location:
  • Phone: 601-236-8300
  • Fax: 601-612-0234
Mailing address:
  • Phone: 601-236-8300
  • Fax: 601-612-0234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROSLYN SMITH
Title or Position: CLINICAL DIRECTOR
Credential: LPC-S
Phone: 601-236-8300