Organization · Type 2 NPI

Convergence Mental Performance and Preparation Lab

Clinical Social Worker · Fairfax, VA

NPI number 1346015815 Active

Practice location

4000 Legato Rd Ste 1100
Fairfax, VA 22033-2893

Call (571) 336-2272 Map

Mailing address

15000 Potomac Town Pl Ste 100-151
Woodbridge, VA 22191-6586

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500XNone listed
Exercise & Sports Psychologist 103TE1100XNone listed
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1346015815

Convergence Mental Performance and Preparation Lab's National Provider Identifier is 1346015815, issued on Nov 15, 2023. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fairfax, VA. The record was last updated on Nov 15, 2023.