Healthcare Provider Details

I. General information

NPI: 1093689697
Provider Name (Legal Business Name): SARA JANE ZWART LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/24/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 LAKE MICHIGAN DR NW STE 103
GRAND RAPIDS MI
49534-4583
US

IV. Provider business mailing address

1908 HOOVER RD
CASNOVIA MI
49318-9506
US

V. Phone/Fax

Practice location:
  • Phone: 616-805-3660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801096433
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: