Withenshaw, Jack Randall

Withenshaw, Jack Randall is an individual health care provider with primary practice located at 1101 Military St , Port Huron MI 48060-5418. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Withenshaw, Jack Randall can be contacted via phone (810) 984-5575.

Contact Information

Primary practice address
1101 Military St Port Huron MI 48060-5418
Phone: (810) 984-5575
Fax: (810) 984-6433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 6802065221 Michigan
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4101006147 Michigan

Profile Details

NPI number 1992968788
LBN Legal business name Withenshaw, Jack Randall
Credentials SW, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 2nd, 2008
Last updated Jul 2nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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