TAHISA JAMISON
NPI 1770058703
Counselor - Mental Health in Clark, NJ

Q: What is Tahisa Jamison's NPI number?

The NPI number for Tahisa Jamison is 1770058703. It was assigned to this individual provider in the NPPES registry on October 5, 2018.

Q: What is Tahisa Jamison's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Tahisa Jamison was last updated on October 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 05, 2018PECOS Enrolled

67 WALNUT AVE STE 207, CLARK, NJ 07066(732) 982-2888(847) 859-5885 Get Directions Write a Review

NPPES record last updated: October 5, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tahisa Jamison NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAHISA JAMISON (NPI 1770058703) is an individual mental health provider in Clark, New Jersey, licensed in (37AC00352100) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in East Brunswick, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1770058703

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameTAHISA JAMISON

Location Address67 WALNUT AVE STE 207Clark, NJ 07066-1640

Mailing Address175 E Hawthorn Pkwy Ste 235Vernon Hills, IL 60061-1454 · (847) 737-8768 · Fax (847) 859-5885

Phone(732) 982-2888

Fax(847) 859-5885

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateOctober 5, 2018

✔ NPI 1770058703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed · 37AC00352100

67 WALNUT AVE STE 207, Clark, NJ 07066

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Secondary Practice Location 1

Location 1465 Cranbury Rd Ste 203East Brunswick, NJ 08816-7600 · Phone (732) 982-2888 · Fax (847) 859-5885

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tahisa Jamison is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2961985528

PECOS Enrollment IDI20260311003122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAMESHA WALKINS LCSW

Social Worker (Clinical)