Convergence Mental Performance and Preparation Lab
Convergence Mental Performance and Preparation Lab is a Professional Counselor in Fairfax, Virginia. Registered with an NPI since 2023.
- In the registry since
- 2023
- Specialties on file
- 3
Practice location Address checks out
4000 Legato Rd Ste 1100Fairfax, VA 22033-2893
Phone: (571) 336-2272
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X |
|---|---|
| Professional Counselor | Taxonomy 101YP2500X |
| Exercise & Sports Psychologist | Taxonomy 103TE1100X |
Record details
| NPI number | 1346015815 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tawana Butler — Owner/Ceo · (817) 913-5428 |
| Other names | Convergence Mental Performance Lab; Convergence Prep |
| NPI enumerated | November 15, 2023 |
| Last updated in NPPES | November 15, 2023 |
| Certification date | November 15, 2023 |
| Mailing address | 15000 Potomac Town Pl Ste 100-151, Woodbridge, VA 22191-6586 |
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Kaitlyn Coots, LPC
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