Leah Devae Bradshaw

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P018030 Issued in NC

Practice address

3000 Latrobe Dr Ste B
Charlotte, NC 28211-5227

Phone

(704) 780-4271

Fax

(888) 261-6694

NPI assigned

Feb 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Monarch

  • Community/Behavioral Health Agency
  • Greensboro, NC
  • NPI 1831465442
  NPD (past)

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1043843725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 EXECUTIVE PARK BLVD STE 120",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031534",
            "telephone_number": "336-577-0966",
            "fax_number": "336-962-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 LATROBE DR STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282115227",
            "telephone_number": "704-780-4271",
            "fax_number": "888-261-6694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Executive Park Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031534",
            "country_code": "US",
            "telephone_number": "336-577-0966",
            "fax_number": "336-962-6739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "LEAH",
        "middle_name": "DEVAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zdenka S Bradley
• Bradley'S Caravan Services
• Hannah Lorraine Bradsell
• Johnnie Mack Bradshaw, PA-C
• Kelly Todd Bradshaw, NP
• London Victoria Bradshaw
• Meghan Sydney Bradsher-James, CRNA
• Erron A Brady, DMD
• Hannah Ruth Brady
• Jennifer Hellmund Brady, MD

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.