MEDICARE: CONVERGENT SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1053278861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONVERGENT SERVICES INC

Provider Business Mailing Address
First Line	:	9816 EMERALD POINT DR UNIT 9
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-6536
Country	:	US
Telephone Number	:	704-400-6786
Fax Number	:

Provider Business Practice Location Address
First Line	:	4944 BRIGHT RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214
Country	:	US
Telephone Number	:	704-400-6786
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KWESI NICHOLS
Credential	:
Telephone Number	:	704-400-6786

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “CONVERGENT SERVICES INC ” Practice Location

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