Tanya D Mizell, NCC LPC CCTP ASDI | |
3763 17th St, Ecorse, MI 48229-1339 | |
(734) 237-7199 | |
Not Available |
Full Name | Tanya D Mizell |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 3763 17th St, Ecorse, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306316724 | NPI | - | NPPES |
1732823 | Other | NATIONAL BOARD FOR CERTIFIED COUNSELORS (NBCC) | |
7A7B6 | Other | CAGE/NCAGE | |
KLDNLGNS98C3 | Other | SAM UNIQUE ENTITY ID | |
14898250 | Other | CAQH PROVIEW |
Entity Name | Unwavering Support Services, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861250490 PECOS PAC ID: 4688013436 Enrollment ID: O20240412003648 |
Mailing Address | Practice Location Address |
---|---|
Tanya D Mizell, NCC LPC CCTP ASDI 3763 17th St, Ecorse, MI 48229-1339 Ph: (734) 237-7199 | Tanya D Mizell, NCC LPC CCTP ASDI 3763 17th St, Ecorse, MI 48229-1339 Ph: (734) 237-7199 |
Mr. Charles E Wasson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500 | |
Jesus Ontiveroz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4646 W Jefferson Ave, Ecorse, MI 48229 Phone: 313-622-9827 | |
Mr. Robert Christopher Miles, Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500 | |
Mrs. Rozalyn Marie Mitchell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500 |