CARLY LACELLE
NPI 1790334829
Psychologist in Portage, MI

Active since September 11, 2019
1611 W CENTRE AVE STE 108, PORTAGE, MI 49024(269) 366-8858 Get Directions Write a Review

NPPES record last updated: May 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2026, Mar 25, 2025, Sep 11, 2019 (3 updates tracked since 2019).

About Carly Lacelle NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY LACELLE (NPI 1790334829) is an individual psychologist in Portage, Michigan, licensed in Michigan (6361007651) and active in the NPI registry since September 2019.

NPPES Registry Identity

NPI1790334829
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameCARLY LACELLE
Location Address1611 W CENTRE AVE STE 108Portage, MI 49024-5344
Mailing Address1611 W Centre Ave Ste 108Portage, MI 49024-5344
Sole ProprietorNo
Enumeration DateSeptember 11, 2019
Last NPPES UpdateMay 6, 20263 updates tracked since enumeration
NPPES CertifiedMay 6, 2026
NPI 1790334829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MI · 6361007651
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 6301017883 (MI)
1611 W CENTRE AVE STE 108, Portage, MI 49024

Accepted Insurance

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Adult Mental Health)
1611 W CENTRE AVE STE 108
PORTAGE, MI 49024

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Lacelle's NPI number?

The NPI number for Carly Lacelle is 1790334829. It was assigned to this individual provider in the NPPES registry on September 11, 2019.

Where is Carly Lacelle located?

Carly Lacelle practices at 1611 W Centre Ave Ste 108, Portage, MI 49024. The listed phone number is (269) 366-8858.

What is Carly Lacelle's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

What insurance does Carly Lacelle accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and UnitedHealthcare list Carly Lacelle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carly Lacelle was last updated on May 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.