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Jack Woodburn, LPC
NPI 1306009196 · on the registry since 2008
Federal exclusion record
The HHS Office of Inspector General publishes a list of individuals and entities excluded from Medicare, Medicaid and other federal health programs. A record on that list carries this NPI.
- Reason
- Licence revoked, suspended or surrendered
- Authority
- Section 1128b4 · permissive · until licence restored
- Excluded
- 2022-07-20
- Recorded as
- Counselor
Matched on NPI alone. OIG asks that any match be confirmed by Social Security or Employer Identification Number, neither of which appears in the public file, so treat this as something to verify rather than something established. Verify at OIG. Our copy of the list is from 2026-09-15. Reinstated parties are removed from each new release, so a person cleared since then may still appear here.
Practice
- Address
- 1101 Military St
Port Huron, MI 48060 - Phone
- (810) 984-5575
- Fax
- (810) 984-6433
- Organisation at this address
- Colonial Woods Missionary Church
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 14
Registry record
- Primary taxonomy
- Professional Counselor
101YP2500X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2008-07-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan