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JAVONTAE BRADLEY
NPI 1689494841
Counselor - Mental Health in Charlotte, NC

Active since October 14, 2024
4108 PARK RD STE 410, CHARLOTTE, NC 28209(980) 949-8990 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Javontae Bradley NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAVONTAE BRADLEY (NPI 1689494841) is an individual mental health provider in Charlotte, North Carolina, licensed in North Carolina (A20178) and active in the NPI registry since October 2024.

NPPES Registry Identity

NPI1689494841
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJAVONTAE BRADLEY
Location Address4108 PARK RD STE 410Charlotte, NC 28209-2262
Mailing Address9404 Perimeter Station Dr Apt 303Charlotte, NC 28216-4474
Phone(980) 949-8990
Sole ProprietorYes
Enumeration DateOctober 14, 2024
Last NPPES UpdateSeptember 11, 2025
NPPES CertifiedSeptember 11, 2025
✔ NPI 1689494841 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · A20178
4108 PARK RD STE 410, Charlotte, NC 28209
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR BANNER LCSWA
Social Worker (Clinical)
4108 PARK RD STE 410
CHARLOTTE, NC 28209
Mecklenburg County (704) 629-8737

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Javontae Bradley's NPI number?

The NPI number for Javontae Bradley is 1689494841. It was assigned to this individual provider in the NPPES registry on October 14, 2024.

Where is Javontae Bradley located?

Javontae Bradley practices at 4108 Park Rd Ste 410, Charlotte, NC 28209. The listed phone number is (980) 949-8990.

What is Javontae Bradley's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Javontae Bradley was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.