Individual
MR. BRADLEY EDWARD KORNEGAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, LCAS
Contact information
Practice address
925 CONFERENCE DR, SUITE D, GREENVILLE, NC 27858-5971
(252) 412-3207
Mailing address
PO BOX 2899, GREENVILLE, NC 27836-0899
(252) 412-3201
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
01/24/2013
Last updated
03/02/2015
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