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General NPI Number Information
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NPI Number | 1417813049
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Entity Type | Organization
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Legal Business Name | JWB AUTISM SUPPORT SERVICES
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 360 E GRAND BLANC RD STE C
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City | GRAND BLANC
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State | MI
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Zip | 48439-3310
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Country | US
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Telephone | 810-230-4224
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Fax | 844-918-0774
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Provider Business Mailing Address
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Address Line | 360 E GRAND BLANC RD STE C
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City | GRAND BLANC
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State | MI
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Zip | 48439-3310
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Country | US
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Telephone | 810-230-4224
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Fax | 844-918-0774
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Authorized Official
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Title or Position | OWNER
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Name | MOLLY BARNHART
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Credential | LPC
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Telephone | 989-482-9444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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