MEDICARE: JOSHUA C WISENBAUGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1265246417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA C WISENBAUGH

Provider Business Mailing Address
First Line	:	15371 APPLE ST
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-9504
Country	:	US
Telephone Number	:	616-796-4960
Fax Number	:

Provider Business Practice Location Address
First Line	:	15371 APPLE ST
Second Line	:
City	:	GRAND HAVEN
State	:	MI
Zip	:	49417-9504
Country	:	US
Telephone Number	:	616-796-4960
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2025
Last Update Date	:	02/06/2025

Similar Medicare Providers

1194260745 — MRS. REBECCA ANN LITTLE
Practice Location Address:

509 FRANKLIN AVE
GRAND HAVEN, MI
49417-1400

Practice Phone: 616-485-8232
Practice Fax:

1720936578 — JENNIFER LANGILL KIKKERT MS, OTR/L
Practice Location Address:

1415 S BEECHTREE ST
GRAND HAVEN, MI
49417-2843

Practice Phone: 616-850-5140
Practice Fax:

1942379284 — TRINITY HEALTH GRAND HAVEN HOSPITAL
Practice Location Address:

1309 SHELDON RD
GRAND HAVEN, MI
49417-2404

Practice Phone: 616-842-3600
Practice Fax: 616-847-5621

1225809320 — MICHAEL JAMES MAJOR
Practice Location Address:

16760 LINCOLN ST
GRAND HAVEN, MI
49417-8864

Practice Phone: 616-317-2690
Practice Fax:

1154277267 — GRACE KETCHMARK
Practice Location Address:

16925 ABILITY WAY
GRAND HAVEN, MI
49417-9325

Practice Phone: 616-935-7606
Practice Fax:

1497601504 — KORA WAKEFIELD
Practice Location Address:

16925 ABILITY WAY
GRAND HAVEN, MI
49417-9325

Practice Phone: 616-935-7606
Practice Fax:

Directions to “ JOSHUA C WISENBAUGH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.