CROWN LEGACY SUPPORTIVE SERVICESLLC NPI 1326435314

NPI Information

NPI: 1326435314
Provider Name: CROWN LEGACY SUPPORTIVE SERVICESLLC
Classification: Social Worker - 1041C0700X
Specialization: Clinical
Entity Type: Organization
Other Name: BRADLEY-REID CORPORATION
Address: 715 E 5TH ST
SUITE 216
CHARLOTTE, NC
ZIP 28202
Phone: (704) 333-5686

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NPI Details

CROWN LEGACY SUPPORTIVE SERVICESLLC is a clinical social worker in Charlotte, NC. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. CROWN LEGACY SUPPORTIVE SERVICESLLC NPI is 1326435314. The provider is registered as an organization entity type.
The provider Other Name Is Bradley-reid Corporation.

The provider's business location address is:

715 E 5TH ST
SUITE 216
CHARLOTTE, NC
ZIP 28202-001
Phone: (704) 333-5686
Fax: (704) 376-1931

The provider's authorized official is Sandra Bradley Reid .
The authorized official title is Chief Executive Officer and has the following contact phone number (704) 333-5686.

The enumeration date for this NPI number is 4/17/2015 and was last updated on 4/17/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251B00000X	Case Management		No
2	251S00000X	Community/Behavioral Health		No
3	252Y00000X	Early Intervention Provider Agency		No
4	253Z00000X	In Home Supportive Care		No
5	347C00000X	Private Vehicle		No
6	385H00000X	Respite Care		No
7	1041C0700X	Social Worker	Clinical	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6008557	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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