Provider Demographics
NPI:1366068298
Name:BRYANT, MICHAEL ANDREW (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL ANDREW
Middle Name:
Last Name:BRYANT
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16126 MAGNOLIA HILL ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-4907
Mailing Address - Country:US
Mailing Address - Phone:407-577-8571
Mailing Address - Fax:
Practice Address - Street 1:16126 MAGNOLIA HILL ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-4907
Practice Address - Country:US
Practice Address - Phone:407-577-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL146681041C0700X
FLSW19990101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical