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Jerry Douglas Lickfelt, CPSS
Peer Specialist in Port Huron, Michigan
NPI 1417622408

Jerry Douglas Lickfelt is a Peer Specialist based in Port Huron, MI. Jerry Douglas Lickfelt practices in Port Huron, MI and has the professional credentials of CPSS. The NPI Number for Jerry Douglas Lickfelt is 1417622408 and holds a License No. (Michigan).

The current practice location address for Jerry Douglas Lickfelt is 3111 Electric Ave, Port Huron, MI and can be reached out via phone at 810-966-8900.

Location: 3111 Electric Ave, Port Huron, MI, 48060-8127
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417622408
Provider Name
Jerry Douglas Lickfelt
Credential
CPSS
Provider Entity Type
Individual
Gender
Male
Address
3111 Electric Ave, Port Huron, MI, 48060-8127
Phone Number
810-966-8900
Fax Number
Provider Enumeration Date
08/11/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3111 Electric Ave
City
Port Huron
State
Michigan
Zip
48060-8127
Phone Number
810-966-8900
Fax Number
person
Provider Business Mailing Address Details
Address
3111 Electric Ave
City
Port Huron
State
Michigan
Zip
48060-8127
Phone Number
810-966-8900
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
(Michigan)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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