Kyra Vandermeulen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451023789 Issued in MI

Practice address

215 Ann Arbor Rd W Ste 206
Plymouth, MI 48170-2251

Phone

(734) 335-4479

NPI assigned

Oct 15, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kyra Black Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1982424941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33129 W CHICAGO ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503788",
            "telephone_number": "630-538-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 ANN ARBOR RD W STE 206",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481702251",
            "telephone_number": "734-335-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMEULEN",
        "first_name": "KYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYRA",
            "last_name": "BLACK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Vanbebber
• Gary Louis Vance, DDS
• Kathleen Vandel, M.A. CCC-SLP
• Sheila Vander
• Andrea Vanderhorst
• Lorri Vanderroest, M.D.
• Jennifer Vanderveen, LLPC
• Ann Vandyke
• Courtney Vanest
• Haley Vanhoose

• Mental Health Counselor in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.