TANYA D MIZELL NCC LPC CCTP2 ASDCS
NPI 1306316724
Counselor - Professional in Southgate, MI

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since November 28, 2018PECOS Enrolled

14799 DIX TOLEDO RD, SOUTHGATE, MI 48195(734) 324-8326(734) 324-8327 Get Directions Write a Review

NPPES record last updated: May 2, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 2, 2026, Jun 29, 2024, Jun 9, 2024 and 5 more (8 updates tracked since 2018).

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About Tanya D Mizell Ncc Lpc Cctp2 Asdcs NPPES

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

TANYA D MIZELL NCC LPC CCTP2 ASDCS (NPI 1306316724) is an individual professional provider in Southgate, Michigan, licensed in Michigan (6401224388) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ecorse.

NPPES Registry Identity

NPI1306316724

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameTANYA D MIZELLCredential: NCC LPC CCTP2 ASDCS

Location Address14799 DIX TOLEDO RDSouthgate, MI 48195-2507

Mailing Address3763 17th StEcorse, MI 48229-1339 · (734) 237-7199

Phone(734) 324-8326

Fax(734) 324-8327

Sole ProprietorYes

Enumeration DateNovember 28, 2018

Last NPPES UpdateMay 2, 20268 updates tracked since enumeration

NPPES CertifiedMay 2, 2026

✔ NPI 1306316724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in MI · 6401224388✔ Licensed in OH · C.2607971

Also ListedCounselorTaxonomy 101Y00000X · License 6401224388 (MI)

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 6401224388 (MI)

14799 DIX TOLEDO RD, Southgate, MI 48195

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Secondary Practice Location 1

Location 13763 17th StEcorse, MI 48229-1339 · Phone (734) 237-7199

Other Identifiers 4

Other1732823National Board For Certified Counselors (nbcc)

Other7A7B6Cage/ncage

OtherKLDNLGNS98C3Sam Unique Entity Id

Other14898250Caqh Proview

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Priority Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tanya D Mizell Ncc Lpc Cctp2 Asdcs is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

MICHELE MARIE LEGLEITNER B.A., S.S.T.

Social Worker