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General NPI Number Information
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NPI Number | 1104717941
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Entity Type | Organization
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Legal Business Name | CONVERGENCE PSYCHOLOGICAL PLC
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 4604 N SAGINAW RD STE L
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City | MIDLAND
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State | MI
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Zip | 48640-2394
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Country | US
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Telephone | 989-817-2905
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Fax | 810-777-7660
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Provider Business Mailing Address
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Address Line | 4604 N SAGINAW RD
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City | MIDLAND
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State | MI
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Zip | 48640-2387
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE SPECIALIST
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Name | ETHAN VOLMERING
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Credential |
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Telephone | 989-817-2905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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