Healthcare Provider Details

I. General information

NPI: 1366330730
Provider Name (Legal Business Name): KELLY BENSINGER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W LAKE LANSING RD
EAST LANSING MI
48823-8527
US

IV. Provider business mailing address

330 W LAKE LANSING RD
EAST LANSING MI
48823-8527
US

V. Phone/Fax

Practice location:
  • Phone: 517-273-2706
  • Fax:
Mailing address:
  • Phone:
  • Fax: 833-740-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELLY L BENSINGER
Title or Position: OWNER
Credential: PMHNP
Phone: 517-281-0146