Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jerry Douglas Lickfelt, CPSS

Individual provider Peer Specialist · NPI 1417622408

Jerry Douglas Lickfelt, CPSS is a Peer Specialist in Port Huron, Michigan. Licensed in Michigan. Registered with an NPI since 2021.

Licensed in
MI
In the registry since
2021
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Practice location Address checks out

3111 Electric Ave
Port Huron, MI 48060-8127
Phone: (810) 966-8900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X (MI)

Record details

NPI number1417622408
Entity typeIndividual (Type 1)
GenderMale
Credentials CPSS
Sole proprietorNo
NPI enumeratedAugust 11, 2021
Last updated in NPPESAugust 11, 2021
Certification dateAugust 11, 2021

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