St Clair County Community Mental Health Authority

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY

Practice address

14675 Downey Rd
Capac, MI 48014-3016

Phone

(810) 395-4343

NPI assigned

Feb 21, 2007

Last updated

Jun 12, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITYAs reported in NPPES

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) 985-8900

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• St Clair County Community Mental Health West-Capac Other name

Medicare fee-for-service enrollment

Enrolled in MI4 enrollments

Enrollment records 4

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Port Huron, MI
  • NPI 1689783672

  O20031118000783, O20040209000604, O20040831000305, O20040901000060

  Same enrollment
• St Clair County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Marine City, MI
  • NPI 1821133265

  O20031118000783, O20040209000604, O20040831000305, O20040901000060

  Same enrollment

Part of

St Clair County Community Mental Health Authority - Sud Services

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Marie Parise, OTR

  • Occupational Therapist
  • Marine City, MI
  • NPI 1881607737
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1306981675",
    "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": "480608127",
            "telephone_number": "810-985-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14675 DOWNEY RD",
            "city": "CAPAC",
            "state": "MI",
            "postal_code": "480143016",
            "telephone_number": "810-395-4343"
        }
    ],
    "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": "2007-02-21",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "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": "810-985-8900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708164",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4349015",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10688",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Clair County Community Mental Health West-Capac",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St Clair County Community Mental Health West-Capac",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melanie Ann Mailloux, LBSW
• Tracy Ann Matthews, LMSW
• Angela Lynn Nester, LMSW
• SDS Pharmacy Inc (Capac Pharmacy, Inc.)
• Amy Lynn Simpson
• St Clair County Community Mental Health Sud Services - Capac
• Marney Beth Studaker-Cordner, LMSW
• Maria Guadalupe Sustaita
• Mary Theel, LMSW
• Holly Topor, LMSW

• Community/Behavioral Health Agency in Capac, MI
• Providers in Capac, MI by specialty
• Community/Behavioral Health Agency in Michigan

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.