Provider Demographics
NPI:1336033646
Name:BRYANT, STEPHEN JR (LMSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:BRYANT
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 MONROE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3119
Mailing Address - Country:US
Mailing Address - Phone:585-642-9895
Mailing Address - Fax:
Practice Address - Street 1:360 WELLINGTON AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1210
Practice Address - Country:US
Practice Address - Phone:585-358-0512
Practice Address - Fax:585-861-6827
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1272811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical