Kelly D Distelrath, LLP - Counselor in Port Huron, MI

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Kelly D Distelrath, LLP is a Psychologist - Clinical based in Port Huron, Michigan. Kelly D Distelrath is licensed to practice in Michigan (license number 6361007549) and her current practice location is 520 Superior St, Port Huron, Michigan. She can be reached at her office (for appointments etc.) via phone at (810) 984-4202.

NPI number for Kelly D Distelrath is 1598976375 and her current mailing address is 1340 Pinecrest Dr, Ferndale, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598976375.

Contact Information

Kelly D Distelrath, LLP
520 Superior St,
Port Huron, MI 48060-3838
(810) 984-4202
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameKelly D Distelrath
GenderFemale
SpecialityPsychologist - Clinical
Location520 Superior St, Port Huron, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1598976375
  • Provider Enumeration Date: 05/24/2007
  • Last Update Date: 03/03/2021

Medical Identifiers

Medical identifiers for Kelly D Distelrath such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1598976375NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health (* (Not Available))Secondary
103TC0700XPsychologist - Clinical 6361007549 (Michigan)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly D Distelrath is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kelly D Distelrath, LLP
1340 Pinecrest Dr,
Ferndale, MI 48220-1608

Ph: (586) 258-0206		Kelly D Distelrath, LLP
520 Superior St,
Port Huron, MI 48060-3838

Ph: (810) 984-4202

Reviews and Comments


Psychologist in Port Huron, MI


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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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