Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1366655896 Deactivated / Inactive NPI Female Practitioner

Tamara L Puckett , LPC

Counselor • Jackson, MS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Tamara Puckett has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 08, 2007
NPI Deactivation Date October 02, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Tamara Puckett, LPC was a registered Counselor practicing in Jackson, MS. Throughout an active medical career spanning 17 years, Tamara Puckett provided care at the practice location at 4500 I 55 N until profile deactivation on 2024-10-02.

Practice Location & Contact Primary Location

Practice Address

4500 I 55 N
Suite 293-S

Jackson, MS 392115930

Telephone 6019825943
Fax 6013624089
Associated Practice Facility / Clinic
🏢 Family Matters First Facility NPI 1356647523

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Jackson, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.0 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
64 Specialists

Practicing in Jackson, MS (892 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License MS 0888

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Holly Ellingburg , MAMFT, LPC

Counselor - Professional

NPI 1063658730

MAMFT, Licensed Professional Counselor

John Owen , COUNSELOR

Counselor - Addiction (Substance Use Disorder)

NPI 1457952665
Terri Coalter , LCSW, BCD

Social Worker - Clinical

NPI 1801048780

Licensed Clinical Social Worker, BCD

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 02, 2024

Record deactivated on October 02, 2024

NPI Profile Active December 19, 2008

NPI status registered as active in NPPES database

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Updated Practice Location December 19, 2008

Registered at 4500 I 55 N, SUITE 293-S, JACKSON, MS 392115930 (Tel: 6019825943)

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Updated Business Mailing Address December 19, 2008

Registered at 4500 I 55 N STE 293S, JACKSON, MS 392115966 (Tel: 6016136088)

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Provider Name / Credentials Updated December 19, 2008

Recorded as TAMARA PUCKETT, LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 19, 2008

Counselor (License #0888 in MS)

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Initial NPI Registration & Enumeration May 08, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366655896
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 08, 2007
Last Update: December 19, 2008
Deactivation Date: October 02, 2024

Mailing Address

4500 I 55 N Ste 293s

Jackson, MS 392115966

Phone: 6016136088

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.