MEDICARE: KELLY POWERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1326996562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELLY POWERS, LLC

Provider Business Mailing Address
First Line	:	2016 GODWIN AVE SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49507-3126
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	967 SPAULDING AVE SE STE E
Second Line	:
City	:	ADA
State	:	MI
Zip	:	49301-3703
Country	:	US
Telephone Number	:	616-965-1298
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELLY POWERS-GUTIERREZ
Credential	:	LMSW
Telephone Number	:	616-965-1298

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “KELLY POWERS, LLC ” Practice Location

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