NPIMap

Organization Active NPI

St Clair County Community Mental Health Authority

Doing business as St Clair County Community Mental Health SUD Services - Broadway

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Marine City, MI
National Provider Identifier
1952152779
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Doing business as
St Clair County Community Mental Health SUD Services - Broadway
Practice address
135 Broadway St
Marine City, MI 48039-1607
Phone
(810) 400-4200
Fax
(810) 765-8451
NPI assigned
Mar 29, 2024
Organization subpart
No

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) 985-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

135 Broadway St
Marine City, MI 48039-1607

Mailing address

3111 Electric Ave
Port Huron, MI 48060-8127
Phone (810) 985-8900

Other names 1

  • St Clair County Community Mental Health SUD Services - Broadway Doing business as

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

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": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1952152779",
    "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",
            "fax_number": "810-985-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 BROADWAY ST",
            "city": "MARINE CITY",
            "state": "MI",
            "postal_code": "480391607",
            "telephone_number": "810-400-4200",
            "fax_number": "810-765-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR COUNTY COMMUNITY MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "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": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Clair County Community Mental Health SUD Services - Broadway",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Clair County Community Mental Health SUD Services - Broadway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marine City, 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.