TANYA D MIZELL MS LLPC CCTP ASDI NPI 1306316724

NPI Information

NPI: 1306316724
Provider Name: TANYA D MIZELL, MS LLPC CCTP ASDI
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
3763 17TH ST
ECORSE, MI
ZIP 48229
Phone: (734) 237-7199
Get Directions

Tanya D Mizell, MS LLPC CCTP ASDI is a mental health counselor in Ecorse, MI. Tanya D Mizell, MS LLPC CCTP ASDI NPI is 1306316724. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3763 17TH ST
ECORSE, MI
ZIP 48229-339
Phone: (734) 237-7199

The NPI 1306316724 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/28/2018 and was last updated on 4/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		6451017830	MICHIGAN	No
2	101YP2500X	Counselor	Professional	6451017830	MICHIGAN	No
3	101YM0800X	Counselor	Mental Health	6451017830	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	14898250	OTHER	CAQH PROVIEW
2	7A7B6	OTHER	CAGE/NCAGE
3	KLDNLGNS98C3	OTHER	SAM UNIQUE ENTITY ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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