Bradley Kornegay, LCSW, Lcas, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C009346 Issued in NC

Legal business name

BRADLEY KORNEGAY, LCSW, LCAS, PLLC

Practice address

925D Conference Dr
Greenville, NC 27858-5971

Phone

(252) 412-3207

Fax

(252) 689-2996

NPI assigned

Mar 24, 2015

Organization subpart

No

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

Authorized official

Name

Bradley Kornegay, MSW, LCSW, LCASNPI 1811235989

Title

Owner

Phone

(252) 412-3207

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley Edward Kornegay, MSW, LCSW, LCAS

  • Clinical Social Worker
  • Greenville, NC
  • NPI 1811235989

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1225422686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2899",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278360899",
            "telephone_number": "252-412-3207",
            "fax_number": "252-689-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925D CONFERENCE DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585971",
            "telephone_number": "252-412-3207",
            "fax_number": "252-689-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY KORNEGAY, LCSW, LCAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "KORNEGAY",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-412-3207",
        "authorized_official_credential": "MSW, LCSW, LCAS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-2786",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Kim Bradby, M.D.
• Haley Carson Braddock, FNP-C
• Heather Braddy, CRT
• Holly Whitehurst Braddy, LPN
• Bradley Home Care Services and Transportation PLLC
• Alexandru Bradu, MD
• Jacqueline Davanzo Brady, NNP-BC
• Jessica Elizabeth Brady, DO
• Ryan Alexander Brady, M.D.
• Barbara Cherry Brafford, PT, DPT

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, 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 Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.