Individual provider Active NPI

Stephen Vinson, EDD, LCSW-QS

  • Clinical Social Worker
  • Gulf Breeze, FL
National Provider Identifier
1104555994
Registry record updated Jun 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22455 Issued in FL
Practice address
3000 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-5623
Phone
(850) 604-3574
NPI assigned
Jun 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 112522 TX
Clinical Social Worker 1041C0700X SW22455 FL Primary
Clinical Social Worker 1041C0700X 0904020629 VA

Addresses

Primary practice location

3000 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-5623

Mailing address

10062 Navarre Pkwy # 5003
Navarre, FL 32566-3013
Phone (850) 604-3574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW22455FLMDClinical Social Worker
112522TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Bridge Counseling and Consulting LLC Clinical CurrentSince Jun 23, 2025 Accepting new patients
Daniels Harbor Therapy Center LLC Clinical PastSince Jun 1, 2022 Accepting new patients

Locations

3000 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 604-3574

10062 Navarre Pkwy
Navarre, FL 32566
Phone (850) 585-9591

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781913600000",
    "number": "1104555994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10062 NAVARRE PKWY # 5003",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325663013",
            "telephone_number": "850-604-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GULF BREEZE PKWY",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635623",
            "telephone_number": "850-604-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "EDD, LCSW-QS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2026-06-20",
        "certification_date": "2026-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "112522",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22455",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904020629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.