Provider Demographics
NPI:1851412951
Name:MCGRATH, STEPHEN JAMES DAVID (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAMES DAVID
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5190 26TH STREET WEST
Mailing Address - Street 2:UNIT A
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-2200
Mailing Address - Country:US
Mailing Address - Phone:941-753-7086
Mailing Address - Fax:941-794-0230
Practice Address - Street 1:5190 26TH STREET WEST
Practice Address - Street 2:UNIT A
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-2200
Practice Address - Country:US
Practice Address - Phone:941-753-7086
Practice Address - Fax:941-794-0230
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00003101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical