Healthcare Provider Details

I. General information

NPI: 1447636899
Provider Name (Legal Business Name): MELANIE HOGETERP LMSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2015
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 RAYBROOK SE SUITE 102-6
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

1623 ROSEWOOD AVE SE
GRAND RAPIDS MI
49506
US

V. Phone/Fax

Practice location:
  • Phone: 616-644-9024
  • Fax: 616-949-9115
Mailing address:
  • Phone: 616-644-9024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801090078
License Number StateMI

VIII. Authorized Official

Name: MRS. MELANIE ANNE HOGETERP
Title or Position: OWNER/THERAPIST
Credential: LMSW
Phone: 616-644-9024