Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tamara T Jackson

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1164061073

Tamara T Jackson is an Addiction (Substance Use Disorder) Counselor in Grand Rapids, Michigan. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

40 Jefferson Ave SE
Grand Rapids, MI 49503-4304
Phone: (616) 456-1443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1164061073
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 26, 2019
Last updated in NPPESDecember 26, 2019
Certification dateDecember 26, 2019
Mailing address40 Jefferson Ave Se, Grand Rapids, MI 49503-4304

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