Provider Demographics
NPI:1942194980
Name:DIEBLER, KELLIE (LPC)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:
Last Name:DIEBLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 LANARK LN
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4240
Mailing Address - Country:US
Mailing Address - Phone:239-272-9425
Mailing Address - Fax:
Practice Address - Street 1:1642 W COLONIAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4725
Practice Address - Country:US
Practice Address - Phone:847-749-0514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor