Provider Demographics
NPI:1720750748
Name:ROBINSON, BRIDGETTE G (LGPC)
Entity type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:G
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 S PULASKI ST STE 4B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2999
Mailing Address - Country:US
Mailing Address - Phone:443-804-3765
Mailing Address - Fax:
Practice Address - Street 1:208 S PULASKI ST STE 4B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2999
Practice Address - Country:US
Practice Address - Phone:443-804-3765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11918101YP2500X
MDLC14172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional