IndividualActive
Kelly Distelrath, LLP
NPI 1598976375 · Clinical Psychologist · Port Huron, MI
Provider details
- NPI number
- 1598976375
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- LLP
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
520 Superior St
Port Huron, MI 48060-3838
Phone: (810) 984-4202
Street-level locationGet directions
Mailing address
1340 Pinecrest Dr
Ferndale, MI 48220-1608
Additional practice locations (1)
- 12220 E 13 Mile RdSuite 300Warren, MI 48093-5000Phone: (586) 258-0206Fax: (586) 258-0201
Registry dates
- Enumerated
- 2007-05-24
- Last updated
- 2021-03-03
- Certified
- 2021-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.