Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK RANDALL WITHENSHAW, SW, LMFT
ActiveMR. JACK RANDALL WITHENSHAW, SW, LMFT is a Marriage & Family Therapist healthcare provider located in PORT HURON, Michigan. NPI 1992968788 is currently active in the NPPES registry. Verify at CMS.
Marriage & Family Therapist · PORT HURON, MI
Registration Details
- NPI Number
- 1992968788
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 2, 2008 (18.079599816906 yrs)
- Last Updated
- Jul 2, 2008
- Licenses
-
6802065221 (MI)4101006147 (MI)
Practice Information
- Address
-
1101 MILITARY STPORT HURON, MI, 480605418Browse MI providers · Browse ZIP 48060
- Phone
- 8109845575
- Fax
- 8109846433
- Primary Specialty
-
Marriage & Family Therapist
106H00000X
- Additional Specialty
- Marriage & Family Therapist
Other Marriage & Family Therapist Providers in PORT HURON, MI
| Name | Credential | NPI |
|---|---|---|
| MRS. GENA MARIE VOIT | MA, MFT | 1245579598 |
| KATHLEEN VON KAMPEN | — | 1467986471 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.