# KELLY DIETZEL, LMFT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740149806
- **Authorized official:** MRS. KELLY BREANNE DIETZEL MS (LMFT)
- **Authorized official phone:** (586) 722-3698

## Contact information

- **Practice address:** 801 S WAVERLY RD STE 100, LANSING, MI 48917-4200
- **Practice address phone:** (586) 722-3698
- **Mailing address:** 801 S WAVERLY RD STE 100, LANSING, MI 48917-4200
- **Mailing address phone:** (586) 722-3698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2026
- **Last updated:** 01/15/2026