Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly D Distelrath, LLP

Individual provider Mental Health Counselor · NPI 1598976375

Kelly D Distelrath, LLP is a Mental Health Counselor in Port Huron, Michigan. Works from 2 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2007
Specialties on file
2
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Practice location Address checks out

520 Superior St
Port Huron, MI 48060-3838
Phone: (810) 984-4202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12220 E 13 Mile Rd, Warren, MI 48093-5000 — (586) 258-0206

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6361007549 (MI)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1598976375
Entity typeIndividual (Type 1)
GenderFemale
Credentials LLP
Sole proprietorNo
NPI enumeratedMay 24, 2007
Last updated in NPPESMarch 3, 2021
Certification dateMarch 3, 2021

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