Organization
BRADLEY KORNEGAY, LCSW, LCAS, PLLC
Active
Organization
BRADLEY KORNEGAY, LCSW, LCAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY KORNEGAY MSW, LCSW, LCAS (OWNER)
(252) 412-3207
Entity
Organization
Contact information
Practice address
925D CONFERENCE DR, GREENVILLE, NC 27858-5971
(252) 412-3207
(252) 689-2996
Mailing address
PO BOX 2899, GREENVILLE, NC 27836-0899
(252) 412-3207
(252) 689-2996
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-2786
NC
1041C0700X
Clinical Social Worker
Primary
C009346
NC
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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