Tanya D Mizell, NCC LPC CCTP2 ASDCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401224388 Issued in MI

Practice address

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone

(734) 324-8326

Fax

(734) 324-8327

NPI assigned

Nov 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1306316724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3763 17TH ST",
            "city": "ECORSE",
            "state": "MI",
            "postal_code": "482291339",
            "telephone_number": "734-237-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326",
            "fax_number": "734-324-8327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3763 17th St",
            "address_purpose": "LOCATION",
            "city": "Ecorse",
            "state": "MI",
            "postal_code": "482291339",
            "country_code": "US",
            "telephone_number": "734-237-7199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZELL",
        "first_name": "TANYA",
        "middle_name": "D",
        "credential": "NCC LPC CCTP2 ASDCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401224388",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.2607971",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401224388",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401224388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFIED COUNSELORS (NBCC)",
            "identifier": "1732823",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAGE/NCAGE",
            "identifier": "7A7B6",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAM UNIQUE ENTITY ID",
            "identifier": "KLDNLGNS98C3",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIEW",
            "identifier": "14898250",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Southgate, MI
• Providers in Southgate, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.