Charles Vermeulen, MS, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301008006 Issued in MI

Practice address

835 Mason St Ste B220
Dearborn, MI 48124-2262

Phone

(313) 561-9064

NPI assigned

Jun 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Modern Psychology Group,PLLC

  • Clinical Psychologist
  • Dearborn, MI
  • NPI 1447701255
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1578765186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE B220",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242262",
            "telephone_number": "313-561-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE B220",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242262",
            "telephone_number": "313-561-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMEULEN",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MS, LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301008006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Paul Versin, DDS
• Roberta Vespa
• Mandy Alyce Vessels
• Vibrant Life Medical Center PLLC

• Psychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.