Provider / Organization | NPI | Date Certified |
---|---|---|
TANYA D MIZELL | 1306316724 | 2024-04-02 |
Tanya D Mizell is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1306316724. Registration indicates Tanya D Mizell is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor, Behavioral Health & Social Service Providers) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Professional, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Professional, Behavioral Health & Social Service Providers) (Counselor, ) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Counselor) (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
Entity Type | Individual |
Provider Name | Tanya D Mizell MS LLPC CCTP ASDI |
Practice Office Address | 3763 17TH ST ECORSE, MI US |
Practice Office Telephone | 7342377199 |
Mailing Address | 3763 17TH ST ECORSE, MI 482291339 US |
Business Telephone | 7342377199 |
Code | Practice | License No State |
---|---|---|
101Y00000X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor Behavioral Health/Substance Abuse/Psychiatry Counselor Behavioral Health & Social Service Providers | 6451017830
MI |
101YP2500X | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Professional Behavioral Health/Substance Abuse/Psychiatry Counselor Professional Behavioral Health & Social Service Providers Counselor | 6451017830
MI |
101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | 6451017830
MI |
14898250 | OTHER | CAQH PROVIEW | |
7A7B6 | OTHER | CAGE/NCAGE | |
KLDNLGNS98C3 | OTHER | SAM UNIQUE ENTI |