Healthcare Provider Details

I. General information

NPI: 1285545152
Provider Name (Legal Business Name): SHARON DIEPENHORST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7502 HIDDEN FOREST DR
HUDSONVILLE MI
49426-9165
US

IV. Provider business mailing address

7502 HIDDEN FOREST DR
HUDSONVILLE MI
49426-9165
US

V. Phone/Fax

Practice location:
  • Phone: 616-340-4650
  • Fax:
Mailing address:
  • Phone: 616-340-4650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHARON DIEPENHORST
Title or Position: CLINICAL SOCIAL WORKER
Credential: LMSW
Phone: 616-340-4650