Healthcare Provider Details

I. General information

NPI: 1861324386
Provider Name (Legal Business Name): STONEBRIDGE PSYCHOLOGICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3513 N OPAL AVE
CHICAGO IL
60634-3029
US

IV. Provider business mailing address

3513 N OPAL AVE
CHICAGO IL
60634-3029
US

V. Phone/Fax

Practice location:
  • Phone: 773-679-9144
  • Fax:
Mailing address:
  • Phone: 773-679-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN WILLIAM BRYANT
Title or Position: FOUNDER
Credential: PSYD, LCPC
Phone: 773-679-9144