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General NPI Number Information
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NPI Number | 1851412951
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Entity Type | Individual
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Provider Name | STEPHEN JAMES DAVID MCGRATH LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5190 26TH STREET WEST UNIT A
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City | BRADENTON
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State | FL
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Zip | 34207-2200
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Country | US
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Telephone | 941-753-7086
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Fax | 941-794-0230
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Provider Business Mailing Address
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Address Line | 5190 26TH STREET WEST UNIT A
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City | BRADENTON
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State | FL
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Zip | 34207-2200
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Country | US
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Telephone | 941-753-7086
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Fax | 941-794-0230
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW0000310
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License Number State | FL
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