NPIMap

Organization Active NPI

St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Port Huron, MI
National Provider Identifier
1295083723
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Practice address
2415 24TH St
Port Huron, MI 48060-6414
Phone
(810) 488-8840
NPI assigned
Aug 15, 2012
Organization subpart
Yes
Parent organization
ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Debra B Johnson
Title
Executive Director
Phone
(810) 966-7886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2415 24TH St
Port Huron, MI 48060-6414

Mailing address

3111 Electric Ave
Port Huron, MI 48060
Phone (810) 985-8900

Other names 2

  • Children's Waiver Other name
  • SED Waiver Other name

National Provider Directory

National Provider Directory
Tax ID family
St Clair County Community Mental Health Authority - Sud Services9 organizations share this tax ID, including this one
Part of
St Clair County Community Mental Health Authority - Sud Services

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1295083723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 ELECTRIC AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-8900",
            "fax_number": "810-985-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 24TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606414",
            "telephone_number": "810-488-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY",
        "enumeration_date": "2012-08-15",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "810-966-7886"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Waiver",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SED Waiver",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SED Waiver",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.