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

Mr. Jack Randall Withenshaw, SW, LMFT

Individual provider Social Worker · NPI 1992968788

Mr. Jack Randall Withenshaw, SW, LMFT is a Social Worker in Port Huron, Michigan. Licensed in Michigan. Registered with an NPI since 2008.

Licensed in
MI
In the registry since
2008
Specialties on file
2
What do these letters mean?
LMFT — Licensed Marriage and Family Therapist
A therapist licensed to treat couples and families.

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Practice location Address checks out

1101 Military St
Port Huron, MI 48060-5418
Phone: (810) 984-5575
Fax: (810) 984-6433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 4101006147 (MI)
Social Worker Taxonomy 104100000X · Licence 6802065221 (MI)

Record details

NPI number1992968788
Entity typeIndividual (Type 1)
GenderMale
Credentials SW , LMFT
Sole proprietorNo
NPI enumeratedJuly 2, 2008
Last updated in NPPESJuly 2, 2008

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