Kalamazoo County has 2.29 marriage and family therapists per 10,000 residents, while 29 Michigan counties have none on record

Picture two couples on the same Tuesday night, both deciding it is time to talk to someone. One lives a few blocks from Western Michigan University in Kalamazoo and finds several marriage and family therapists within a short drive. The other lives outside Bay City and searches the same way, only to find that the nearest names are in another county. Same state, same need, very different maps. We counted where Michigan’s marriage and family therapists actually practice to see how wide that gap is.

Kalamazoo County leads Michigan with 2.29 marriage and family therapists per 10,000 residents

Across Michigan there are 730 individual NPI records for marriage and family therapists (MFTs) with a Michigan practice location. Against a population of 10,077,761, that works out to 0.72 per 10,000 residents. Kalamazoo‘s county leads by a wide margin at 2.29 per 10,000 (60 records), about three times the state figure. Ingham County, home to East Lansing and Lansing, is second at 1.62, followed by Kent County around Grand Rapids at 1.48 and Isabella County (Mount Pleasant) at 1.39.

At the other end, 29 of Michigan’s 83 counties have no individual MFT record at all. We list them, with their populations and shortage designations, in our companion report on Michigan counties without a marriage and family therapist.

What the density map shows: university counties, big metros and a few small surprises

The top of the list is dominated by counties with universities and graduate training programs: Kalamazoo, Ingham, Kent, Isabella and Washtenaw (0.97). That pattern fits how the profession is built, since new therapists train and complete supervised hours where programs and clinical placements exist, though our data cannot prove why any individual practices where they do.

Population size and density are not the same thing. Oakland County has the most records in the state (159) and a density of 1.24, fifth overall. Wayne County has the third-largest count (74), yet because it is Michigan’s most populous county, its density is only 0.42 per 10,000, below the state figure. Residents of Detroit and the rest of Wayne County share a much thinner local supply than raw counts suggest. Macomb sits at 0.53 and Genesee at 0.60.

Small counties can swing high on very few people. Baraga County (1.22) and Oscoda County (1.19) each rank in the top seven on a single record. Houghton (1.06, four records) and Grand Traverse (1.04, ten records) also rank high. A single therapist opening or closing a practice in a county of 8,000 people moves its rate more than ten new therapists would in Kent.

Concentration is the clearest pattern. The seven counties of Oakland, Kent, Wayne, Kalamazoo, Macomb, Ingham and Washtenaw hold 520 of the 730 records (71.2%) while home to about 54.7% of Michigan residents. Only 15 counties are above the 0.72 state figure; Gratiot matches it exactly.

Michigan counties with the most and fewest marriage and family therapists per 10,000 residents

How we counted therapists per county

• Who is counted. Individual (Type 1) records in the CMS National Plan and Provider Enumeration System (NPPES) carrying taxonomy code 106H00000X, Marriage & Family Therapist, with a Michigan practice location, retrieved October 8, 2026. The NPI is a federal identifier that health care providers obtain for billing and administration.
• Where they are counted. Each record was placed in a county using the centroid of its practice ZIP code (Census 2023 ZCTA Gazetteer) within Census cartographic county boundaries. One record could not be matched to a county.
• Population. County totals come from the American Community Survey 2020-2024 5-year estimates. The rate is records divided by population, times 10,000. The 71.2% and 54.7% shares above are our own arithmetic: 520 divided by 730, and the combined 5,511,197 residents of those seven counties divided by 10,077,761.
• Bay County, precisely. Bay County’s zero is real for individual records. The NPPES registry does list two NPIs in Bay City with the MFT taxonomy, but both are organization (Type 2) records, a regional hospital and a counseling agency, so they are not counted. Therapists who work there may bill under the organization’s number or under another taxonomy.

Limitations: what an NPI count cannot tell you

• An NPI record does not prove an active Michigan license. Check any therapist on LARA, as described in our guide to verifying a Michigan therapist license.
• Many professionals who do couples and family work are licensed counselors, social workers or psychologists and use those taxonomies. They are not in this count.
• Therapists who practice only under an employer’s organization NPI, or who never obtained an NPI, are invisible here.
• A practice address is not a caseload. One record may be a full-time clinician or someone seeing a handful of clients, and some list an address but work mostly by video.

What this means for couples and families in low-density counties

A low number does not mean people in a county need more therapy, and it says nothing about any family’s relationships. It describes how far the nearest office might be. For many people that distance is the barrier: a 90-minute round trip on a winter evening is hard to keep up every week.

Video sessions can widen the options for people in counties with few or no local MFTs. Michigan generally requires a Michigan license to practice a health profession here, and licensure follows where the client is located, so you need a therapist licensed in Michigan and you need to be physically in Michigan during each session. Online care does not fix every gap: it depends on a private space and a reliable connection, and some people simply prefer to meet in person. Iryna Morhunova-Sutton, LLMFT, meets with individuals, couples and families by video anywhere in Michigan; our page on online therapy in Michigan explains how it works. For the licensed and limited-licensed split behind these numbers, see Michigan’s LMFT and LLMFT workforce.

How often this ranking is updated

We refresh the therapist counts quarterly from NPPES and update county populations each time the Census Bureau publishes a new ACS 5-year release.