Organization Active NPI

Convergence Psychological PLC

  • Psychologist
  • Midland, MI
National Provider Identifier
1104717941
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CONVERGENCE PSYCHOLOGICAL PLC
Practice address
4604 N Saginaw Rd Ste L
Midland, MI 48640-2394
Phone
(989) 817-2905
Fax
(810) 777-7660
NPI assigned
Jul 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ethan Volmering
Title
Administrative Specialist
Phone
(989) 817-2905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

4604 N Saginaw Rd Ste L
Midland, MI 48640-2394

Mailing address

4604 N Saginaw Rd
Midland, MI 48640-2387

National Provider Directory

National Provider Directory

Locations

4604 N Saginaw Rd
Ste L
Midland, MI 48640
Phone (989) 817-2905

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1104717941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 N SAGINAW RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 N SAGINAW RD STE L",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402394",
            "telephone_number": "989-817-2905",
            "fax_number": "810-777-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVERGENCE PSYCHOLOGICAL PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "VOLMERING",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "ADMINISTRATIVE SPECIALIST",
        "authorized_official_telephone_number": "989-817-2905"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.