Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Thomas Charles Fuller, PHD

Individual provider Clinical Neuropsychologist · NPI 1598705675

Dr. Thomas Charles Fuller, PHD is a Clinical Neuropsychologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
Specialties on file
3
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

2851 Charlevoix Dr SE Ste 323
Grand Rapids, MI 49546-7092
Phone: (616) 458-0692
Fax: (616) 458-8129
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 6301006879 (MI)
Clinical Neuropsychologist Taxonomy 103G00000X · Licence 6301006879 (MI)
Psychologist Taxonomy 103T00000X · Licence 6301006879 (MI)

Record details

NPI number1598705675
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedJune 7, 2006
Last updated in NPPESOctober 18, 2023
Certification dateOctober 18, 2023
Mailing address161 Ottawa Nw, Ste 300c Human Resource Associates, Grand Rapids, MI 49503

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