# FOUR CROWNE LEGACY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Crowne Initiative Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033092903
- **Authorized official:** DR. EDNORA BRADLEY MASON DNP, APRN, PMHNP-BC (PARTNER)
- **Authorized official phone:** (757) 826-1300

## Contact information

- **Practice address:** 6147 JEFFERSON AVE OFC 2, NEWPORT NEWS, VA 23605-1511
- **Practice address phone:** (757) 504-2191
- **Mailing address:** 317 PEACH TREE CRES, NEWPORT NEWS, VA 23602-7494
- **Mailing address phone:** (757) 504-2191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2025
- **Last updated:** 11/24/2025