Healthcare Provider Details

I. General information

NPI: 1174477152
Provider Name (Legal Business Name): STEPHEN DANYAEL BRIDGES MSW, RSCWI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9210 ESTERO PARK COMMONS BLVD STE 7
ESTERO FL
33928-6395
US

IV. Provider business mailing address

6020 DREXEL LN APT 923
FORT MYERS FL
33919-5254
US

V. Phone/Fax

Practice location:
  • Phone: 239-427-1833
  • Fax:
Mailing address:
  • Phone: 239-478-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW20488
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: