Provider Demographics
NPI:1033479167
Name:VAN TONGEREN, SARA ANNE (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:VAN TONGEREN
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:SHOWALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:430 E 8TH ST STE 246
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3751
Mailing Address - Country:US
Mailing Address - Phone:616-827-7807
Mailing Address - Fax:616-828-0392
Practice Address - Street 1:27 W 25TH ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4910
Practice Address - Country:US
Practice Address - Phone:616-827-7807
Practice Address - Fax:616-828-0293
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040075631041C0700X
MI68010940901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical