Healthcare Provider Details

I. General information

NPI: 1255752986
Provider Name (Legal Business Name): FAITH A SMITH LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FAITH A DOERZBACHER

II. Dates (important events)

Enumeration Date: 12/23/2013
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date: 04/19/2017
Reactivation Date: 03/13/2025

III. Provider practice location address

1024 SUPERIOR STREET
PORT HURON MI
48060-3936
US

IV. Provider business mailing address

3315 ELK STREET
PORT HURON MI
48060-2036
US

V. Phone/Fax

Practice location:
  • Phone: 810-966-0099
  • Fax: 810-696-7339
Mailing address:
  • Phone: 586-823-1028
  • Fax: 810-696-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451024169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: