Provider Demographics
NPI:1275377178
Name:REDEMPTIONTRIPLE-C LLC
Entity type:Organization
Organization Name:REDEMPTIONTRIPLE-C LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPERATOR : PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:MCLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, MA, NCC, LPC
Authorized Official - Phone:202-588-6467
Mailing Address - Street 1:4315 50TH ST NW STE 100
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-4369
Mailing Address - Country:US
Mailing Address - Phone:202-558-6467
Mailing Address - Fax:
Practice Address - Street 1:4315 50TH ST NW STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4369
Practice Address - Country:US
Practice Address - Phone:202-558-6467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty