Individual provider Active NPI

Michel Dean Tozer, MSED., LCPC

  • Professional Counselor
  • Danville, IL
National Provider Identifier
1053649301
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180-005085 Issued in IL
Practice address
3545 N Vermilion St
Danville, IL 61832-1100
Phone
(217) 651-6801
NPI assigned
Nov 25, 2009
Last updated
Nov 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.005086 IN
Professional Counselor 101YP2500X 180-005085 IL Primary

Addresses

Primary practice location

3545 N Vermilion St
Danville, IL 61832-1100

Mailing address

3545 N Vermilion St
Danville, IL 61832-1100
Phone (217) 651-6801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240524003425 IL Practitioner - Mental Health Counselor 7719329465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Two Roads Wellness Clinic, LLCGroup PAC ID 9638536220, 9 clinicians

Practice addresses (Care Compare)

3545 N Vermilion St
Danville, IL 61832-1100
Phone (217) 651-6801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180-005085ILMDProfessional Counselor
180.005086INMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MDT Holistic Healing and Counseling Professional Current Accepting new patients
Two Roads Wellness Clinic, LLC CurrentSince Apr 11, 2024 Accepting new patients
Two Roads Wellness Clinic, LLC CurrentSince Apr 11, 2024 Accepting new patients

Locations

3115 Village Office Pl
Champaign, IL 61822
Phone (217) 531-4101

3545 N Vermilion St
Danville, IL 61832
Phone (217) 442-8611

Interoperability endpoints

  • Direct secure messaging: michel.tozer.1@30412.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1053649301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321100",
            "telephone_number": "217-651-6801",
            "fax_number": "217-651-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321100",
            "telephone_number": "217-651-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOZER",
        "first_name": "MICHEL",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "MSED., LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-25",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IN",
            "license": "180.005086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-005085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.