Healthcare Provider Details

I. General information

NPI: 1255299640
Provider Name (Legal Business Name): EMPOWERING THERAPY MI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6147 28TH ST SE STE 14
GRAND RAPIDS MI
49546-6934
US

IV. Provider business mailing address

3777 BUTTRICK AVE SE
ADA MI
49301-9221
US

V. Phone/Fax

Practice location:
  • Phone: 616-207-3075
  • Fax:
Mailing address:
  • Phone: 616-460-9068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JILL GUNDERSON
Title or Position: OWNER/THERAPIST
Credential: LMSW
Phone: 616-460-9068