Provider Demographics
NPI:1255752986
Name:SMITH, FAITH A (LLPC)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:A
Last Name:SMITH
Suffix:
Gender:
Credentials:LLPC
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:A
Other - Last Name:DOERZBACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3315 ELK STREET
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-2036
Mailing Address - Country:US
Mailing Address - Phone:586-823-1028
Mailing Address - Fax:810-696-7339
Practice Address - Street 1:1024 SUPERIOR STREET
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3936
Practice Address - Country:US
Practice Address - Phone:810-966-0099
Practice Address - Fax:810-696-7339
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2025-03-13
Deactivation Date:2017-04-19
Deactivation Code:
Reactivation Date:2025-03-13
Provider Licenses
StateLicense IDTaxonomies
MI6451024169101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional