Convergence Mental Performance and Preparation Lab
NPI 1346015815ActiveOrganization· Social Worker, Clinical· Fairfax, VA
Social Worker, Clinical in Fairfax, Virginia, registered in NPPES in November 2023. The authorized official on file is Tawana Butler, LCSW, Owner/Ceo.
Overview
| NPI | 1346015815 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 15, 2023 |
| Last updated in NPPES | Nov 15, 2023 |
| Certified by provider | Nov 15, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
| Counselor, Professional | 101YP2500X | — | — |
| Psychologist, Exercise & Sports | 103TE1100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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