Provider Demographics
NPI:1083595318
Name:BRIDGING THE GAP PEER SUPPORT SPECIALIST LLC
Entity type:Organization
Organization Name:BRIDGING THE GAP PEER SUPPORT SPECIALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:804-982-6889
Mailing Address - Street 1:2508 CHAMBERLAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-4223
Mailing Address - Country:US
Mailing Address - Phone:804-982-6889
Mailing Address - Fax:
Practice Address - Street 1:2508 CHAMBERLAYNE AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-4223
Practice Address - Country:US
Practice Address - Phone:804-982-6889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty