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NPI Code Detail

MEDICARE: THE BRIDGE COUNSELING AND CONSULTING LLC

MEDICARE: THE BRIDGE COUNSELING AND CONSULTING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1063234813
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE BRIDGE COUNSELING AND CONSULTING LLC
Provider Business Mailing Address
First Line : 10062 NAVARRE PKWY
Second Line :
City : GULF BREEZE
State : FL
Zip : 32566-3013
Country : US
Telephone Number : 850-604-3574
Fax Number :
Provider Business Practice Location Address
First Line : 3000 GULF BREEZE PKWY
Second Line :
City : GULF BREEZE
State : FL
Zip : 32563-5623
Country : US
Telephone Number : 850-604-3574
Fax Number :
Authorized Official
Title or Position : COO
Name : DR. STEPHEN A. VINSON
Credential : EDD, LCSW
Telephone Number : 850-604-3574
Provider Enumeration Date : 10/31/2024
Last Update Date : 06/20/2025

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Directions to “THE BRIDGE COUNSELING AND CONSULTING LLC ” Practice Location

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