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NPI Code Detail

MEDICARE: ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY

MEDICARE: ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1295083723
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Provider Business Mailing Address
First Line : 3111 ELECTRIC AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060
Country : US
Telephone Number : 810-985-8900
Fax Number : 810-985-7620
Provider Business Practice Location Address
First Line : 2415 24TH ST
Second Line :
City : PORT HURON
State : MI
Zip : 48060-6414
Country : US
Telephone Number : 810-488-8840
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DEBRA B JOHNSON
Credential :
Telephone Number : 810-966-7886
Provider Enumeration Date : 08/15/2012
Last Update Date : 06/12/2025

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Directions to “ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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